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Frontiers in Psychology 01 frontiersin.org
The illusion of inclusion:
contextual behavioral science and
the Black community
SonyaC.Faber
1, IshaW.Metzger
2, JosephLaTorre
1,
CarstenFisher
3 and MonnicaT.Williams
1,3, 4*
1 School of Psychology, University of Ottawa, Ottawa, ON, Canada, 2 Department of Psychology, Georgia
State University, Atlanta, GA, United States, 3 Behavioral Wellness Clinic, LLC, Tolland, CT, United States,
4 Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
Anti-racism approaches require an honest examination of cause, impact, and
committed action to change, despite discomfort and without experiential
avoidance. While contextual behavioral science (CBS) and third wave cognitive-
behavioral modalities demonstrate ecacy among samples composed of
primarily White individuals, data regarding their ecacy with people of color, and
Black Americans in particular, is lacking. It is important to consider the possible
eects of racial stress and trauma on Black clients, and to tailor approaches and
techniques grounded in CBS accordingly. Wedescribe how CBS has not done
enough to address the needs of Black American communities, using Acceptance
and Commitment Therapy (ACT) and Functional Analytic Psychotherapy (FAP)
as examples. Wealso provide examples at the level of research representation,
organizational practices, and personal experiences to illuminate covert racist
policy tools that maintain inequities. Towards eradicating existing racism in the
field, weconclude with suggestions for researchers and leadership in professional
psychological organizations.
KEYWORDS
acceptance and commitment therapy, functional analytic psychotherapy, African
Americans, Black Americans, racism, weaponization of policy, organizations, diversity
Highlights
‑ ere is a mismatch between research on Black mental health and actual health needs.
‑ Black people need help for anxiety and PTSD more than substance abuse.
‑ Ecacy data on contextual behavioral therapies for Black people is lacking.
‑ Racist policy tools hinder inclusion and research on the Black community.
‑ Examples illustrate weaponization of policy and power hoarding in CBS communities.
‑ Conclusions provide practical steps for anti‑racist organizational transformation.
Introduction
“Power concedes nothing without a demand. It never did and it never will. … e limits of
tyrants are prescribed by the endurance of those whom they oppress.”
— Frederick Douglass
OPEN ACCESS
EDITED BY
Vivian Afi Abui Dzokoto,
Virginia Commonwealth University,
UnitedStates
REVIEWED BY
Jessica Young Brown,
Virginia Commonwealth University,
UnitedStates
Lisa Spanierman,
Arizona State University, UnitedStates
Arthur Andrews,
University of Nebraska-Lincoln, UnitedStates
*CORRESPONDENCE
Monnica T. Williams
monnica.williams@uottawa.ca
RECEIVED 05 May 2023
ACCEPTED 04 October 2023
PUBLISHED 30 October 2023
CITATION
Faber SC, Metzger IW, La Torre J, Fisher C and
Williams MT (2023) The illusion of inclusion:
contextual behavioral science and the Black
community.
Front. Psychol. 14:1217833.
doi: 10.3389/fpsyg.2023.1217833
COPYRIGHT
© 2023 Faber, Metzger, La Torre, Fisher and
Williams. This is an open-access article
distributed under the terms of the Creative
Commons Attribution License (CC BY). The
use, distribution or reproduction in other
forums is permitted, provided the original
author(s) and the copyright owner(s) are
credited and that the original publication in this
journal is cited, in accordance with accepted
academic practice. No use, distribution or
reproduction is permitted which does not
comply with these terms.
TYPE Review
PUBLISHED 30 October 2023
DOI 10.3389/fpsyg.2023.1217833
Faber et al. 10.3389/fpsyg.2023.1217833
Frontiers in Psychology 02 frontiersin.org
What is contextual behavioral science?
Contextual Behavioral Science (CBS) is a research paradigm
that underlies the development of Acceptance and Commitment
erapy (ACT), Relational Frame eory (RFT), Functional
Analytic Psychotherapy (FAP), and other similar third wave
cognitive‑behavioral modalities that are grounded in Skinnerian
behaviorism (Kohlenberg et al., 1993). CBS is a system of
philosophical assumptions, scientic values, and methodological
commitments that drive theory and practice. With its roots in
Western scientism, CBS strives to be objective, empirical, and
evidence‑based (Vilardaga et al., 2009). In addition to being
theoretical, CBS has been adopted by scholar‑practitioners and
other clinicians in the eld of mental health and therefore has a
direct eect on client care (Varra et al., 2008). ere are several
important facets of CBS, but, for the purpose of this paper, wewill
beusing ACT and FAP as examples that are representative of the
issues at hand.
Acceptance and commitment therapy
ACT is an approach that is based on Buddhist principles and
values such as mindfulness, cognitive defusion, and coping with
distressing thoughts and uncomfortable feelings. It encourages people
to embrace their current thoughts and feelings rather than avoid them
or feel guilty for them, which in turn helps to resolve symptoms
associated with a range of mental health conditions such as anxiety,
depression, OCD, addiction, and substance abuse, which have all been
found to benet from ACT (Wetherell et al., 2011; Bramwell and
Richardson, 2018; Osaji etal., 2020). In addition to targeting thoughts
and cognitive processes, ACT also combines strategies and techniques
grounded in behavioral therapy (e.g., meditation, mindfulness)
through emphasizing the self‑acceptance to develop psychological
exibility, which is one’s ability to cope with change and try new things
(Fledderus etal., 2013).
e other major tenet of ACT in addition to acceptance of
thoughts and feelings is commitment. ACT encourages clients to
become committed to acceptance as well as certain behavioral
techniques and, through this model, directs clients to act in ways that
allow them to face problems directly rather than avoiding stress
(Hayes etal., 2013). is can look like committing to actions that help
facilitate experiential learning and embracing challenges with a goal
being to exercise psychological exibility. e opposite of
psychological exibility is called experiential avoidance (EA), which
is characterized by adversity to change and resistance to trying new
things (Biglan etal., 2008). is is when people avoid unpleasant
thoughts and feelings, which is believed to help perpetuate symptoms
associated with psychopathologies such as anxiety disorders, OCD,
and PTSD.
It is important to note, however, that ACT has not been suciently
studied in all populations and data supporting its ecacy among
diverse groups is lacking. While ACT may help a variety of specic
behavioral problems, it does not address the fact that individuals from
dierent ethnoracial backgrounds may experience the approach
dierently (Sobczak and West, 2013). us, there is a need for
clinicians to beethnoracially‑sensitive when it comes to using ACT
with diverse clients.
Functional analytic psychotherapy
FAP is a behaviorally based, experiential and relational approach
to psychotherapy in which therapists focus on dyadic interactions in
session to shape the interpersonal behaviors, develop emotional
awareness, and practice the self‑expression necessary for clients to
create and maintain close relationships with others (Kohlenberg and
Tsai, 2007). In FAP, clinicians model practicing vulnerability and
honesty with clients with the goal of identifying a number of dierent
clinically relevant behaviors, which are targets for change (CRB1),
behaviors that demonstrate clinical improvements (CRB2), and client
interpretations of behaviors (CRB3). Given that interpersonal
challenges are common problems across a range of disorders, FAP has
broad applicability (Wetterneck and Hart, 2012).
FAP is similar to many other CBT interventions because it focuses
on making measurable behavioral change and includes assignments
for clients to complete between sessions, but the distinguishing
characteristic of this treatment is its reliance on building a strong
therapeutic relationship as the primary vehicle for client change. In
FAP, a genuine and corrective therapeutic relationship serves as the
basis for clients to learn healthy communication and relating, and to
repair dysfunctional patterns of interpersonal functioning they may
have outside of therapy. is dyadic relationship is collaborative with
respect to treatment plans and powerful in promoting learning and
change, fostering motivation, and keeping clients engaged in treatment
(Miller etal., 2015).
Purpose of this paper
e authors of this paper are a diverse group of clinicians and
researchers, living and working in varied cultural contexts. e rst
author lives in Germany and is an experienced neuroscientist and
pharmaceutical professional, specializing in clinical development and
social justice issues. e second author is a rst generation African
American, researcher and licensed clinical psychologist who teaches
and provides clinical supervision at Georgia State University, a top
research university in the Southeast UnitedStates. e third author is
a queer White person completing their doctorate in experimental
psychology at the University of Ottawa, with a Masters from Harvard
University in Religious Studies. e fourth author is an African
American behavioral specialist and psychedelic integration therapist
in training who completed his Master’s in Behavioral Psychology at
Pepperdine University. e senior author is a Black clinical
psychologist, former member of the Association of Contextual
Behavioral Science (ACBS) and Canada Research Chair for Mental
Health Disparities at the University of Ottawa, where she studies
disparities and racialization.
Collectively, the authors have been concerned for many years
about the apparent lack of CBS scholarship focused on Black people
and about the lack of representation of Black people in ACBS, notably
in the ACT and FAP communities. e purpose of this paper is to
discuss how those who have developed these modalities have not
included the voices and needs of Black people in their work and in the
leading professional organization that supports CBS.
e lead authors of this paper are Black women who count
themselves fortunate to follow the steps of their foremothers in speaking
out for social change. Notably, as soon as Black American women had
Faber et al. 10.3389/fpsyg.2023.1217833
Frontiers in Psychology 03 frontiersin.org
access to higher education in the late 19th century, they also began
working from within educational institutions as a force for justice (Bell
etal., 2021). Wenote that it is dicult to get papers about the impact of
race on power published due to racial bias in the publication and peer‑
review process (Buchanan etal., 2021; Strauss etal., 2023). e same
forces that minimize and exclude Black people in education, psychology,
and professional organizations also attempt to silence Black people when
they speak up against mistreatment and will assert that Black people are
unqualied to provide a true account of their own experiences. Wereject
this notion and recognize it as yet another form of anti‑Black oppression.
e structure of this paper is rst to present the empirical evidence
regarding the inclusion of Black Americans in research, research
priorities, and as participants in studies using these methodologies.
Second, weshow with examples the power dynamics of the ACBS
structure through reports about treatment of Black people, review
indications of a lack of inclusion, and note initial inroads for inclusion.
Finally, we illuminate racist policy tools used by ACBS through
individual and personal stories of Black professionals about their
experience in this community, and weoer suggestions for beginning
the healing process and promoting positive change in representation
and inclusion in the eld. is paper is not meant to bea systemic
review, rather a critical assessment of Black mental health needs and
experiences within the context of CBS.
Race and racism
Racism is a system of beliefs, practices, and policies based on race
that operate to provide advantages to those with historical power –
White people in the US and most other Western nations (e.g., Canada,
Western Europe, Australia, etc.). Race is a made‑up social construct used
to group people based on shared physical features and presumed
ancestry. Race has no biological basis and was born from White
supremacy, an ideology that presumes the superiority of White people
and inferiority of People of Color (Smedley and Smedley, 2005; Haeny
etal., 2021).
Racism, with its roots in White supremacy, operates hierarchically,
with White people on the top, Black people at the bottom, and Asian
people generally falling in between. is hierarchy is mediated by skin
color (colorism), whereby people with darker skin of any race are
considered lesser than lighter skinned persons of that same race.
Colorism causes people to bedevalued in the US, Canada, Europe, Latin
America, and many Asian countries (Dixon and Telles, 2017; Jablonski,
2021). For example, White‑skinned people in Latin American countries
have privilege over darker‑skinned persons, even though in the US
we tend to consider them all Hispanic. Even so, in the US, White
Hispanic Americans are still advantaged over their darker‑skinned
counterparts, with disparate outcomes (Cuevas etal., 2016). Hispanic
used to beconsidered a racial group in the US, but it is now considered
an ethnic group instead, as per the US Census Bureau, illustrating how
race is determined by social decisions and not biology (Borrell and
Echeverria, 2022).
Anti‑blackness is a type of racism focused specically against Black
people. It has been described as a theoretical framework that illustrates
and explains the dehumanization of Black people, including disdain,
disrespect and disgust of all things connected to Black people (Bell etal.,
2021). e eld of psychology perpetrates the same anti‑Black biases,
stereotypes, and hatred that exist in the rest of our society. Due to
experiences with anti‑Black racism, Black people in Western society
have a well‑founded fear of discrimination, a mistrust in health service
systems, and suer due to inaccurate myths about Black people (e.g.,
pathological stereotypes). Most medical school curricula frame race as
a “biological risk factor” rather than a social one, which implies that
disparities in health are inborn and the dierences wesee in mental
health are due to natural causes and can be explained without
implicating racism (Haeny etal., 2021). is misconception harms both
the treating clinician and the client of color because it pathologizes race
rather than racism, whereas it is the racism that is the risk factor
(Noonan etal., 2016; Alang, 2019). Only addressing the stigma of a
mental health disorder without addressing the racism does a disservice
to the person seeking treatment (Alang, 2019).
Decits in empathy have been identied as a correlate of racist
behavior, and multiple studies including both White and Black samples,
document that people exhibit greater empathic resonance to those with
a similar skin color (Azevedo etal., 2013; Homan etal., 2016; Harjunen
etal., 2021). e converse is true regarding White people’s perception of
(and perhaps, ability to empathize with) the pain experienced by Black
people. Specically, brain imaging reveals anti‑Black racial biases
wherein the pain of Black individuals is perceived to beless distressing
and more tolerable than the pain of White people or even a purple “space
alien” (Berlingeri etal., 2016; Harjunen etal., 2021). is racial bias in
empathy has been associated with racial bias in social behavior as well
(Han, 2018). In order to work eectively across racial dierences and
even nd motivation to conduct research that will benet people from
dierent racial groups, cross‑racial empathy is vital. ese racial biases
are with and in us due to our learning history and must beovercome to
become ethically and culturally competent researchers and therapists.
In addition to individual biases, organizations and institutions also
carry racial biases, and these are built into the rules, policies and
procedures. ese constructs, called institutional racism, function in the
background to arrive at discriminatory outcomes without a single
individual needing to engage in explicitly biased behavior. is has been
well documented in education, academic publishing, and the discipline
of psychology (Williams, 2019; Avery et al., 2022; Dupree and
Kraus, 2022).
For the purposes of this paper, weuse the term Black in reference
to African Americans, dark‑skinned Africans, and all people who are
descendants of the African diaspora (of partial or full African ancestry).
White is being used to describe people who trace their origins to
Europe, have lighter skin, and in general who do not have any visible
Black African, Asian, or other Indigenous ancestry (Haeny etal., 2021).
Mental health priorities in the Black
community
Needs of the Black community
A survey conducted by the Kaiser Family Foundation and ESPN’s
“e Undefeated” explored African Americans’ experiences of being
Black in America, utilizing a dual‑frame (landline and cell phone)
random digit dial methodology (N = 777). It was found that a majority
of Black men and women, regardless of age, income, and education,
believe it is a bad time to beBlack in America, with increases in this
percentage being 37% among Black men and 44% among Black
women from 2006 to 2020 (Hamel etal., 2020).
Faber et al. 10.3389/fpsyg.2023.1217833
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Authors of this survey suggest that the disproportionate impact of
the COVID‑19 pandemic on Black families and the frequent media
coverage of police violence towards Black Americans in the summer of
2020 may impact the perception of personal belonging in America.
When exploring personal and familial concerns amongst Black
respondents, more than a third stated nancial concerns and COVID‑
19‑related concerns as their top priority (Hamel etal., 2020). Authors
found that in addition to housing aordability, lower cost of healthcare,
higher paying jobs, and college aordability, two‑thirds of respondents
prioritized racism as a major concern (Pougiales and Fulton, 2019).
ese stressors can lead to mental health disorders (e.g., racial
trauma) that disproportionately impact the Black population in the US
(Williams etal., 2021b). erefore, the mental health priorities of Black
communities cannot be expected to be identical with those of
White communities.
Dierences in mental health between Black
and White communities
It is well‑documented that there are racial dierences in mental
disorders in the UnitedStates between Black and White populations.
Black Americans on average experience higher rates of psychosocial
stressors than White Americans, but at the same time historically had
the same or better overall mental health than White individuals (Louie
and Wheaton, 2018; omas Tobin etal., 2022). e validity of this
paradox has been consistently demonstrated in adult populations,
however, not only do Black communities exhibit lower levels of mental
health disorders, but there are also racial dierences in the prevalence
among categories of mental health diagnoses between Black and
White Americans. ese racial dierences also dier across
generational cohorts.
It is important to keep in mind that, although Black people have
similar or lower rates of common mental disorders than White
individuals, according to the existing published studies, when they do
suer from mental disorders these are of a greater duration, more
severe, and more disabling among the Black population; and in addition,
Black Americans are less inclined to nd and receive competent mental
health services. is means that the unmet mental health care needs of
Black Americans exceed that of the White community (Noonan etal.,
2016; Alang, 2019).
Younger cohorts of Black people have higher odds of being
diagnosed with anxiety than White people, and the magnitude of
anxiety disorder is higher in younger cohorts (Louie and Wheaton,
2018). In addition, for younger generations, the rate of increase in
anxiety disorders exceeded the rate for White individuals over the same
time period (Figure1). e sharp increases in the numbers of Black
Americans suering from anxiety disorders is attenuated for mood and
impulse control disorders but also signicant.
In comparison, Black Americans do not have substance abuse
disorders in either past or current generations to the same extent as
White Americans, although Black Americans are punished
disproportionately more severely by society for drug use (Alexander,
2010). A recent study of 37,860 patients in fact found that Black mothers
had a higher likelihood of receiving a drug test during delivery
compared with White patients, regardless of their substance use history.
eir chances however of a positive test result was lower than for White
mothers and other racial groups, demonstrating the greater societal
emphasis on unearthing and addressing substance use in Black
communities based on racist stereotypes (Bor et al., 2018; Jarlenski etal.,
2023). A simple PubMed search points to a mismatch between studies
on Black mental health and the actual mental health needs (Black
“substance abuse” yields 2027 studies versus Black “anxiety disorder”
resulting in 297). ere is an overrepresentation of CBT RCTs on
substance use as compared with all other mental health issues when
looking at trials specically designed for African American
participation. is is indicative of a mental health establishment with its
own implicit biases in regard to Black people (Jarlenski etal., 2023).
Mental health provision may disturbingly beset up to oer services in
instances where society at large perceives Black individuals to need
treatment (substance abuse) rather than in areas where they are more
likely to require competent mental health services, such as anxiety and
mood disorders (Smith etal., 2022). It is well‑documented that, due to
a lack of empathy, White clinicians oen misinterpret mood symptoms,
resulting in over diagnosis of Black people with disorders such as
schizophrenia compared to White patients (Schwartz and Blankenship,
2014; Smith etal., 2022; Faber etal., 2023a).
e increases in diagnoses of impulse control disorder and anxiety
in particular for Black cohorts, can beexplained in part by historical
changes that occurred between 1957 and 2004 (Louie and Wheaton,
2018). Rates of child poverty increased between 1974 and 1983 for both
Black and White Americans but had a more profound eect on Black
individuals, at the same time the unemployment rate for Black
communities grew from 1962 to 1985 from 13 to 22%, with over 38,000
Black school workers red in retaliation in the aermath of school
desegregation (Lutz, 2017). e percentage of Black parents furthermore
with a college degree declined from the middle cohort (22%) to the
youngest cohort (19%), and between 1970 and 1990 the number of
single mother households increased among Black women with the
Black‑White dierence in nonmarital births growing from 32 to 50% in
this period. Many of these trends are a result of the US war on Black
people which resulted in imprisonment for Black men in America
increasing three‑fold between 1969 and 1999. is devastated families
and communities who were le to suer the socioeconomic and
emotional consequences of targeted mass incarceration (Alexander,
2010; Louie and Wheaton, 2018).
Examining the subcategory of posttraumatic stress disorder
(PTSD), which was classied as an anxiety disorder in the NCS‑R, there
are also dierences between Black and White populations. ree studies
examining the prevalence rates among the US population of PTSD
using large national samples weighted to the population reported
similar results (Roberts etal., 2011; Alegría etal., 2013; McLaughlin
etal., 2019). In contrast to depression, anxiety, and substance disorders
which are lower among Black Americans, PTSD has a higher prevalence
among Black people, with a higher odds of lifetime PTSD than White
Americans (OR = 1.25) likely due to greater exposure to adversity and
discrimination across the lifespan relative to White individuals
(Andrews etal., 2015; McLaughlin etal., 2019). Ongoing disparities in
treatment indicate a need for investment in culturally competent
treatment options (Roberts etal., 2011; Williams etal., 2022).
PTSD is dened by the DSM‑5 as a process in which a person has
an initial exposure (directly or indirectly) to trauma, followed by
symptoms rooted in the exposure causing multiple disruptions in the
daily life of the one suering from the disorder. e DSM‑5 guidelines
were updated to bemore inclusive of the harmful eects of newer
aversive or chronic forms of bias than were the previous fourth
edition (i.e., chronic exposure to aversive stimuli). is new expanded
denition for PTSD provides some room for the reality that the Black
Faber et al. 10.3389/fpsyg.2023.1217833
Frontiers in Psychology 05 frontiersin.org
community already lives with higher rates of PTSD, in part from
chronic stressors in the media (Himle etal., 2009; Smith etal., 2022).
A more signicant emotional injury for Black people is racial trauma,
which is related to PTSD but oen has a dierent etiology and
treatment requirements (Williams etal., 2021a; Smith etal., 2022).
Racial trauma has been studied for over 20 years by Black scholars,
but there has been scarce funding for empirical studies, and only
recently have established clinical tools and diagnostic criteria been
published (Carter, 2007; Williams etal., 2018).
Faced with these dierences, it stands to reason that mental
health priorities for Black people should beculturally relevant and
cater to those disorders with high prevalence in the population and
those that are rapidly increasing. One of the major issues in
examining data from studies with data that were collected in the
2000’s is that, at that time, there was no recognition or validated
measure to assess the eects of racial trauma. e rise in “anxiety
disorders” documented in publications is likely to hide the existence
of racial trauma which was not considered at the time of these studies.
e appreciation of racial trauma requires a therapeutic
remedy whose parameters are only now being dened (Metzger
etal., 2021; Williams etal., 2021a, 2022). e relevance of CBS for
Black people in the future must depend on how thoroughly Black‑
specic therapeutic structures (paradigms) and skills are imparted
to those therapists who will betreating these patients. In eect, all
CBS therapists must update their knowledge and vocabulary and
seek the necessary retraining and continuing education on these
new protocols to beconsidered procient to oer meaningful
therapy to POC suering due to racialization.
Why younger cohorts experience greater
anxiety
Studies using more recent data from a 2011–2015 National Survey
surveyed Black adults with unmet mental health needs (N = 1,237) and
highlight some reasons for greater anxiety among younger cohorts.
One such study surprisingly found greater unmet needs among Black
cohorts with higher education levels (Alang, 2019). Specically, Black
college students ages 18–25 reported stigma as a signicant barrier to
professional mental health services. Furthermore, across all ages,
employment and college education were associated with increased
odds of experiencing stigma wherein the more education a Black
person had, the greater the increase in the reports of marginalization
and ineective treatment (Alang, 2019).
Younger cohorts have higher education levels and their
exposure to White institutes and power structures are currently
greater than in previous generations. The fact that younger
cohorts are coming into competition with White cohorts for
middle class jobs (which in older generations were cordoned off
for the White male population) means that Black exposure to
professional malice, envy, rancor, resentment, and disaffection is
higher than in previous generations (McDonald et al., 2018).
Essentially, because Black individuals in the middle class compete,
work and are evaluated alongside White persons, and exposure to
racial discrimination increases with upward class mobility, the
issue of double discrimination based on race and social status
exacerbates the resulting mental health consequences of racism
(Noonan etal., 2016; Alang, 2019).
FIGURE1
Characteristics (Percentage and Standard Deviation of Adolescent Survey Respondents in a Study of Race, Birth Cohort, and DSM-IV Mental Disorders,
by Race and Cohort, National Comorbidity Survey Adolescent Supplement (2001-2004) and National Comorbidity Survey Replication (2001-2003).
Mood disorders: major depressive episode, dysthymia, bipolar disorder I, or bipolar disorder II, Anxiety disorders: panic disorder, agoraphobia, social
phobia, general anxiety disorder, post traumatic stress disorder, or separation anxiety disorder, Impulse control disorders: oppositional defiant disorder,
conduct disorder, attention deficit disorder or intermittent explosive disorder, and Substance use disorders: alcohol abuse, alcohol dependence, drug
abuse or drug dependence. Plotted from a table in Louie and Wheaton (2018).
Faber et al. 10.3389/fpsyg.2023.1217833
Frontiers in Psychology 06 frontiersin.org
Taking this information into account, it may be easier to
understand why a Black person may think that a White mental health
provider may not have their best interests in mind or even
beimplicitly working against the client’s true mental health needs
(Bergkamp etal., 2022).
Meeting the needs of the Black
community: how can CBS move these
goals forward?
CBS is a research paradigm underpinning therapies ultimately
designed to improve treatment of mental disorders. e rst study on
ACT was published 30 years ago in 1986 and since then, as of 2019,
over 325 randomized controlled trials have been carried out using
ACT. More than 20 meta‑analyses have been published as well, with
most studies reporting results that favor ACT with no
contraindications for use (Gloster etal., 2020). Although ACT and
similar CBS intervention strategies such as FAP have been shown to
beeective for treating and managing symptoms associated with a
number of mental health conditions, weneed to determine if there is
evidence for its ecacy and safety in diverse populations, and in
particular, racially marginalized individuals. It is possible that ACT
and FAP could behelpful to members of Black communities, yet
treatment protocols may still need to betailored and customized for
work with clients in a way that creates an ethos of ethnoracially and
culturally‑safe care.
Relevance of ACT for the Black
community
Although ACT has been used in dierent countries, it cannot
beassumed that outcomes are generalizable between US populations
of non‑White versus White persons given the mental health
disparities already documented between US Black and White
communities. Black Americans face the same psychological stressors
as every other racial group in addition to daily racial discrimination
and microaggressions, thus the ecacy of ACT must betested outside
of mostly White frameworks.
ACT RCTs for Black mental health
It is important to distinguish between the few ACT randomized
trials that include people of color and the even smaller subset that
focused specically on their mental health. In a recent study, it was
found that papers focused on the mental health of non‑White
individuals were underrepresented, and those specically for
African Americans dropped to only a handful. Out of 100 assessed
ACT studies published between 2002 and 2022in 34 dierent
journals (25 were excluded due to missing demographic
information), the remaining 75 included 10,914 participants.
Among these participants, 8,010 (73%) were White and 1,212 (11%)
were Black. Most studies (84%) focused on ACT interventions for
specic clinical concerns, including anxiety, general distress,
reducing stigma, and working with mental health professionals. Ten
(13%) studies had majority non‑White samples and one study had
a fully Japanese sample. e diversity of targets in the selected
studies made it dicult to compare results based on race. While the
studies reviewed included Black individuals, the relatively small
sample sizes of this population across studies precluded the ability
to infer the eectiveness of ACT interventions for this group
without subgroup analyses. Most studies were not designed to
assess mental health in Black communities. Notably, none of the
studies provided analyses of outcomes based on ethnoracial
dierences and only eight (Table1) studies (11%) had a majority of
participants of color or reported on dierential outcomes for racial
and ethnic minorities, with two of these studies authored by
individuals from underrepresented racial and ethnic groups (Misra
etal., 2023).
Although inclusion of Black participants as per the US Census is
perhaps adequate, the participation of marginalized ethnic groups per
study is too low to assess racial dierences in treatment response, and
the studies were not designed to do so. is makes the generalizability
of the pooled data questionable (Printz etal., 2019; Misra etal., 2023).
Of these studies, two specically examined racial dierences and
found no dierences in treatment ecacy.
A more recent search found 64 studies in which Black patients
again were included, however only a handful had a specific focus
on mental health of the Black community in the US. Of the few,
one is an anti‑smoking cell phone app, with findings derived from
a secondary analysis. As Black Americans generally suffer from
substance abuse at lower rates than White Americans, the more
salient mental health need for Black Americans is therapy for
anxiety, rather than substance use, yet there is an
overrepresentation of the former compared with the latter type of
research (Louie and Wheaton, 2018; Banks etal., 2021; Jahn etal.,
2021; Santiago‑Torres etal., 2021).
A webpage of ACBS identied another study conducted on a
non‑White population: Lundgren etal. (2006) conducted an RCT
showing that a 9‑h ACT protocol reduced seizures in people with
epilepsy, while a placebo had no eect. e participants were all
non‑White SouthAfricans from majority ethnic groups with low
socio‑economic status living in a residential center. Although ACBS
inclusion of this on their “minorities” page implies it may berelevant,
since these SouthAfricans are not minorities and do not categorize
themselves according to American racial norms, the actual relevance
of this study for what the title of the webpage terms “minorities”
is unclear.
Use of ACT for Black people in other
studies (not RCTs)
We conducted a search of the APA PsycInfo Database for
additional psychology papers using ACT with Black Americans and
found only a handful of relevant journal articles and one book chapter.
e book chapter is about utilization of ACT in a case study of a single
rst‑generation STEM African American woman with academic,
nancial, emotional, and familial stressors (Gant, 2020). e case
represents an example of how African American college students’
access to STEM careers remains low and highlights how the
psychological exibility model in ACT can address the unique
challenges of Black clients if clinicians focus on holistic growth in the
counseling process.
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e rst ACT peer‑reviewed paper examines the feasibility of
using ACT in 9 African American adolescents with ADHD, learning
disorders, or behavior problems to improve congruence between
behaviors and values (Murrell Steinberg et al., 2014). e study
(although likely not adequately powered due to its small sample size)
found signicant reliable change on the Behavior Assessment Scale for
Children, suggesting that ACT could be eective in improving
behavior and may have clinical use in youth.
e second paper included 11 adolescent patients with depression,
only 5 of whom were African American (4 identied as multiracial,
and 2 were White). All were given 3 sessions of motivational
interviewing and 12 sessions of ACT, and while also underpowered,
the results showed some improvements in depressive symptoms (Petts
etal., 2017).
e last paper identied in our search was a recent pilot study
(N = 20) documenting pre‑post decreases in internalized racial
oppression and shame, and psychological distress in Black women
treated with ACT (Banks etal., 2021). ACT is considered a method
which is particularly eective for anxiety disorders, and as such this
paper is much needed and timely.
In examining these few papers, wesee that although the samples
were primarily African American, most were not a priori designed
for African Americans. Further, the sample sizes were very small
and the data presented was preliminary. Although these studies
make useful contributions, this data is not sucient to establish that
ACT is a relevant and useful technique that will improve the mental
health of African Americans, especially as some of these treatments
address stereotypical issues (school diculties, behavior problems)
as opposed to priority areas as identied by research or Black
communities. e lack of Black participation and leadership in the
CBS community contributes to the lack of research relevant for
these populations.
ACT to reduce racial prejudice
ere is some limited research that ACT can help reduce racial
prejudice, which is an issue of great concern to Black Americans. In
Lillis and Hayes (2007), undergraduates (N = 32) enrolled in two
separate classes on racial dierences were exposed to ACT exercises
and an educational lecture from a textbook on the psychology of racial
dierences in a counterbalanced order. In this study, only the ACT
intervention was eective in increasing positive behavioral intentions
aer 1‑week follow‑up. ese changes were associated with other self‑
reported changes that t with the ACT model, such as greater
acceptance and exibility.
Using some of these same techniques, Williams etal. (2020a)
developed the Racial Harmony Workshop (RHW), to reduce racial
biases and microaggressions and promote interracial connection
among college students in a pilot study. e RHW was designed to
increase connectedness across racial groups, using principles and
techniques from ACT and FAP. Results indicated positive benets for
both Black and White participants (N = 44), including improved mood
and increased positive feelings towards Black people for the White
students, as well as increased ethnic identity for the Black students.
White students in both conditions showed a decreased likelihood of
committing microaggressions, and those in the RHW condition also
showed a decreased likelihood of having microaggressive thoughts
and increased gains over time. A related pilot study to reduce racism
in medical students found similar results (Kanter etal., 2020).
TABLE1 ACT studies featuring participants of color.
Ethnicity or race
included
Eight ACT randomized controlled trials including identifiable Non-White
samples
Reference
Majority Non‑White Non‑White participants in a study comparing ABBT with CT for test anxiety demonstrated improved test
scores aer treatment.
Brown etal. (2011)
All Japanese ethnicity Japanese college students studying in the UnitedStates experienced improved mental health and increased
psychological exibility aer 2 months of ACT bibliotherapy
Muto etal. (2011)
50% Black Mental Health
Professionals
Combining ACT with applied behavioral analysis training resulted in improved general distress, particularly in
those who actively practiced the ACT skills, and this improvement was greater than applied behavioral analysis
alone, especially for those who were initially more distressed
Bethay etal. (2013)
Over 50% women of color e eectiveness of cognitive‑and acceptance‑based coping skills to avoid consumption of sweets was
compared, and results showed that acceptance‑based consumption group experienced reduced rates of cravings
and level of consumption, especially for those that reported greater awareness of the food environment and
increased emotional eating
Forman etal. (2013)
67% Black college age men In men with gambling disorder, increased psychological exibility and present‑moment awareness was
experienced aer receiving 8 h of individual sessions of ACT, compared with no treatment
Dixon etal. (2016)
78% POC
22% White participants
A study comparing ABBT with treatment as usual found that ABBT improved attendance to medical
appointments, illness‑related experiential avoidance, willingness to disclose HIV status, and number of HIV
disclosures in people living with HIV
Moitra etal. (2017)
51% POC
49% White
Both ACT and CBT were found to improve symptoms in a study comparing them for social anxiety disorder,
although this improvement was more prevalent in the CBT group
Herbert etal. (2018)
27% Black
25% Latine
A majority non‑White sample of individuals suering from mild to moderate traumatic brain injury had
improved psychological distress, increased psychological exibility, and committed action aer receiving eight
sessions of ACT
Sanders etal. (2022)
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It is encouraging that research is being carried out to use ACT
creatively to reduce the eects of racial prejudice and bias in society.
is is an area that has a pressing need in today’s environment that
remains understudied, but more problematic is that there are no
reports of it actually being implemented in organizational structures
(juries, police forces, schools). Further, the fact that there are only 3
papers and no grants for scale‑up studies since 2007 speaks to lost
opportunities and lack of will to follow‑through on these promising
initial reports (Gordon, 2022).
Relevance of FAP for Black people
Given the increasing numbers of Black people requiring and
seeking mental health care, there is a growing need to enhance cultural
competence in therapeutic interventions. Because of its emphasis on
reciprocal vulnerability and empathetic responding, FAP is an
excellent modality for incorporating sensitive cultural factors into
ethnically and racially diverse client‑therapist dyads (e.g.,
Vandenberghe, 2017; Williams etal., 2020b). Use of FAP can make
treatment more genuine and relevant for underserved and racialized
clients. An assessment of functional and non‑functional behaviors of
both therapists and clients can beexamined from a FAP perspective
and used to build alliances across dierences, explore experiences of
racism and discrimination, identify biases in the therapist or clients,
and resolve microaggressions in sessions which can otherwise rupture
the therapeutic alliance (Miller etal., 2015). Nonetheless, there has
been a notable lack of FAP publications focused on the Black
experience. In light of the unique mental health history and specic
needs of the Black community as outlined above, it is worth examining
how FAP has been failing the Black community and analyzing the
context of these experiences through the lens of its Black members.
Retaliation at FAP/ACT workshop and
policy weaponization
Although the hope is that mental health clinicians will bemore
sensitive and aware than most, even professionals who aspire to
beanti‑racist can cause harm if their biases are unchecked. is can
only beremediated through purposeful anti‑racist work, otherwise
these prejudices cause harm even within the CBS community. It is
oen dicult for those who do not experience anti‑Black racism to
envision how these processes actually play out, therefore weprovide
real examples to illustrate how these issues aect real people and to
document these transgressions in the context of the historical struggle
for Black equality. In the rst of three examples (Box 1), all of which
permission to share has been granted by the victim, an anti‑racism
training was organized by diverse trainers, and the 5 expert clinicians
gathered on the West Coast to lead a three‑day workshop that included
several graduate student clinician attendees and therapists of color.
Apart from the Box, both Black and White involved FAP persons
were consulted on the wording of the incidents.
Here it is worth pointing out using this illustrative example
(Box 1) how the organization within the current system functioned to
protect the White individual who transgressed at the expense of harm
to the Black trainer and participants of color (i.e., Gaertner and
Dovidio, 2008; Okun etal., 2019). In an organizational shortcoming,
a proposed ACT/FAP follow‑up workshop by the White trainer
(Box 1), who had publicly demonstrated a lack of cultural‑sensitivity,
was accepted by ACBS without POC involvement. Aer being
confronted by another trainer due to the previous issues, this person
refused to step down from the leadership of the workshop and did not
add any trainers of color to the planned training.
Following the failure of professional mediation, several of the trainers
and participants who had been impacted by the lead trainer’s aggressive
behavior at the previous workshop reported their concerns directly to
ACBS conference organizers, who expressed shock upon realizing their
oversight. ey also said, “If wehad known it was all White people
teaching, we would not have approved it,” and aer some extended
deliberation cancelled the workshop for that summer. ACBS had invited
the Black trainer (Box 1) to lead the workshop since many people had
already registered, but the Black trainer declined, fearing retaliation from
the ousted White trainer. As an alternative, they discussed inviting the
Black trainer for the subsequent conference. When the next ACBS was
planned, however, the Black trainer was not invited to host a workshop
but instead told that they were considered inadequately qualied by the
conference organizers, despite national prominence and having written a
CBS book on this topic. is kind of retaliatory action is oen observed
when whistleblowers shine light on organization misdeeds (Ahern, 2018).
While the Black trainer missed out on this opportunity, from a systemic
level, it is important to note that the White trainer continued as a CBS
trainer and retained his title as an ACBS Fellow and Certied FAP Trainer,
despite a subsequent complaint from another co‑trainer of color who was
also worried about him causing harm to people of color.
is example is important because it illustrates how policy and
power dynamics in organizations are used to covertly discriminate
(Okun etal., 2019). Most prominent here is “weaponization of policy”
which can take two forms. In the rst, an organization has a lack of
clear standards or qualications for a position, as seen above. is is
used to plausibly deny the position to a minoritized person and
permits non‑White experts to beheld to a higher standard than White
insiders. If the policies are unclear or there are no written policies,
those entrusted with enforcing the rules have the power to apply
dierent standards to arrive at unjust outcomes (Okun etal., 2019;
Faber etal., 2023b). e ip side of this is having a dened standard
that is only enforced for minoritized individuals, these can bewritten
or unwritten rules. An example of an unwritten rule that applies only
when writing about issues such as Whiteness and racism and aects
primarily people of color, is the higher burden of proof, which
increases the requested references by reviewers, likelihood of rejection,
and time to publication (Avery etal., 2022).
e other tool observed here is power hoarding, which includes
the withholding of information such that decision‑making is clear to
those with power and unclear to those without it. Finally, these are
aversive racism tactics. A White supremacist culture organization will
use these policies repeatedly to arrive at a plausibly deniable
discriminatory outcome without explicitly targeting any one
individual, although oen harming and putting non‑White people at
a disadvantage (Okun etal., 2019; Chen etal., 2021). Aversive rules are
based on misdirection or deception and can bedicult to change or
perceive because they are constructed to appear, as if they were just,
although their outcomes are discriminatory. It is like saying that
everyone can appeal to their legal advisor, diversity oce, or
university, but if only one side has a lawyer or university, or there is no
diversity oce, the outcome will always beunjust.
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FAP trainings pose barriers to inclusion for
Black trainees
Although not nearly as well‑known as ACT, the FAP community
is growing, with members spread around the world. At face value, it
appears to be a very diverse group of empathic clinicians and
researchers working to restore to CBT the heart that it seemed to have
lost along the way. In fact, one of the two founders of the modality is
an Asian American woman, with a erce commitment to making the
gospel of FAP available worldwide through a series of regular
gatherings for the community through the MeetUp platform called
Awareness, Courage, and Love (ACL). Awareness, courage, and love
(also termed “strong caring” or “responsiveness”) are said to embody
the key principles of FAP.
Many leaders in the FAP community hail from various Latin
American countries, creating the appearance of diversity. But a closer
look reveals that nearly all of these leaders are considered White in
their countries of origin. It is notable that out of more than 100
certied FAP trainers globally, at the time of the writing of this paper
there were no Black trainers. ere were, however, a handful of Black
psychologists who are nearly certied as FAP trainers. One of these
“nearly certied” trainers was concerned about feedback from young
Black therapists who were so disturbed by Level 1 FAP training, that
they broke o or disengaged from the training process. Following
interviews with those involved, it was found that the sentiments
communicated by some trainees were very similar, despite absence of
contact with one another. e issue had to do with the disconnect
between the emotional vulnerability that the participants (Black and
White) were being asked to display towards each other in the training
and the violation of that vulnerability by the White participants from
the onset, due to a lifetime of Western conditioning, which oen
denies the lived Black experience (DiAngelo, 2018; Dupree and Kraus,
2022). Some of the Black therapists who disengaged from the training
expressed both reluctance to express emotional vulnerability, as well
as negative eects of over‑expression of emotional vulnerability in the
training. Across these instances, the emotional expression of the
White therapists overshadowed the experiences of the Black therapists
and furthered their disengagement in the process.
It is important to appreciate that it is not the responsibility of a
Black person engaged in training to educate their White classmates to
prevent harm or cope with having their experiences invalidated
during a training, especially given that those classmates are already
therapists. But this issue recurs because many White people have been
living a life which requires ignorance of racism to justify an egalitarian
self‑concept of non‑complicity in an unfair system (Azevedo etal.,
2013; Bergkamp et al., 2022; Smith et al., 2022). As such, White
trainees tended to reexively deny or minimize painful experiences of
racism shared by fellow trainees of color. Correspondingly, many
Black trainees felt it would beunwise to remove their armor to allow
themselves to be emotionally injured in the service of
experiential learning.
If the FAP leadership had ascribed to an anti‑racist process, they
would share power and consult Black members with more insight and
empathy, and learn about the psychological dangers involved in
training for certication, which is an order of magnitude more
emotionally draining for Black trainees than White ones (Bergkamp
etal., 2022). Issues of power and privilege have been explicated in FAP
scholarship previously. Terry etal. (2010) underscore ethical mandates
by explaining, “that as therapists weshould become aware of power
and privilege in the therapeutic context, because without intention or
awareness wemay beengaging in behaviors that promote inequality
and injustice at the expense of our clients,” and in this case, trainees as
well (p.98). Problem‑solving around this issue could look like anti‑
racism training instituted as a prerequisite to FAP training, which
would have promoted safety and allowed Black and White participants
to enter on more equal emotional footing. Although White learners
will bemore likely to need anti‑racism training, research indicates that
Black people benet as well (Williams etal., 2020a), so this would
begood for everyone (Williams etal., 2021b).
To bring these concerns to the FAP leadership, in January of 2022,
one of the few Black almost‑FAP trainers called a meeting of FAP
leaders and several Black therapists who had completed Level 1
training. All of the Black almost‑FAP trainers were present as well as
two White certied FAP trainers who had helped organize the
meeting. No other FAP trainers decided to attend. Aer describing the
issue and coming up with some suggestions – among these to institute
a Black‑only FAP training session, the Black FAP almost‑trainers
asked to which Black FAP‑certied trainer they could submit their
suggestions, at which point it was made clear that there were no Black
FAP trainers, and therefore, no one in leadership to receive or
BOX 1 Perspective: an incident of racism from a Black educator.
Disturbing issues with a White FAP‑certied trainer started in the months prior to the event, when this individual demanded and was eventually allowed to take charge of a
FAP/ACT diversity workshop, initially conceived and organized by a Black trainer.
While sharing his own personal antiracist journey during the event, herefused to acknowledge the role of White privilege in his success and described himself as “a crusader.”
When some participants of color objected to this, hebecame defensive. At the end of the day, hewas confronted by other participants at the event and the White trainer became
aggressive, such that the other four trainers had to intervene on the rst evening of the workshop. e observed behavior was experienced by participants as rude, insulting,
and argumentative. Several of the participants were deeply hurt and a few students cried. e problem was so severe that hewas removed as a trainer from the workshop for
the second day – a unanimous decision by the other four workshop leaders. Although the White lead trainer was brought back in a lesser capacity for the nal day, hepersisted
in his aggression by making unprovoked bizarre and spiteful comments toward the Black trainer.
is particular individual was now known to the CBS community to beunsafe, but hepersisted in trying to conduct more of these trainings. Although academically qualied,
the trainer was not consistently capable of cultural humility. is individual shortly thereaer applied to conduct the same ACT/FAP anti‑racism workshop for an ACBS
conference, without involving any trainers of color. Because of the harm previously caused by this individual, the Black trainer tried unsuccessfully to persuade the White
trainer not to proceed, voicing fears that more harm would come to vulnerable participants.
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Frontiers in Psychology 10 frontiersin.org
implement the suggestions. e lack of inclusiveness which became
salient to both White and Black trainers at that moment le all
participants discomforted and bere of immediate solutions.
FAP certification double standards
Interestingly, both of the well‑qualied Black almost‑trainers were
psychologists who had completed far above and beyond all
requirements, except the submission of a practice sample – a live
recording of them conducting FAP therapy with a client. Neither
psychologist felt their clients of color would be comfortable being
recorded and allowing White people to scrutinize their private sessions;
one felt it would bean abuse of power to ask this of their clients, who
are keenly aware of the power and privilege gap between minoritized
populations. As noted by Terry etal. (2010), “e therapeutic encounter
consists of social behavior and its context is vulnerable to the same
cultural and societal practices that empower and privilege members of
certain social groups while disempowering others” (p.110). is is why
both psychologists were doubtful that White people could assess their
work within its proper cultural context. Of note, other certifying bodies,
such as the American Board of Professional Psychology, provide several
options for providing practice samples (e.g., recordings of supervision
activities) but this had not been accommodated in the FAP system. at
being said, once FAP leaders became aware that their certication rules
created systemic barriers to Black people being recognized as trainers,
they took steps to provide alternatives to this requirement and shortly
thereaer certied their rst Black FAP trainer.
Completing all the requirements to become a FAP trainer is
extensive and includes publishing papers and organizing/co‑teaching
FAP workshops. Part of the training requires the applicant to receive
FAP therapy or coaching from another FAP therapist. However, the
experience of one of the Black almost‑trainers (Box 2) demonstrates
two issues which are used to alienate and exclude Black people from
positions of power in organizations; lack of empathy and policy
weaponization (inequitable application or enforcement of rules based
on race; Okun etal., 2019). e lack of care and empathy demonstrated
in this example (Box 2) is why many Black trainees have felt reluctant
or unable to engage in vulnerable FAP training with White clinicians.
From an organizational perspective however, what is particularly
notable is the unjust application of (unwritten) rules. When the FAP
almost‑trainer reported having completed the training requirements
understood to be required for certication to the FAP leadership
(Box 2), she was told that her coaching would not count unless she
worked with a female trainer as well for at least 10 sessions at her own
additional expense. A male colleague (White) also working toward
certication, was required to do only 6 coaching sessions with only one
individual in FAP leadership, provided for free. As above, this
weaponization of policy (race‑based arbitrary application of unwritten
rules) is a critical reason why Black people have a harder time attaining
positions of power in organizations (Okun etal., 2019; Chen etal., 2021).
Anti‑racism approaches require centering the voices, opinions,
and perspectives of people of color (Williams etal., 2022). Rather than
power hoarding, an equitable system would invite the perspectives
and presence of marginalized people and make changes to policies and
procedures based on their input. On the other hand, White
supremacist structures are anti‑empathetic, rigid, individualistic, and
do not make space for those with dierent lived experiences (Okun
etal., 2019). Sometimes organizations may make positive changes to
appear more equitable, but if White people are making the nal
decisions, this is still White supremacy. Psychologists should know
that strong anti‑racist measures are required to steer against the
structural racism norms that are historic, deeply rooted, and oen
invisible to White people (Sue, 2017). As such the FAP certication
process has been neither equitable nor anti‑racist (Okun etal., 2019;
Chen etal., 2021; Dupree and Kraus, 2022). e biased outcome – lack
of Black certied trainers – is itself evidence of a biased process.
ACBS shows White bias by excluding
Black people from power
ACBS was developed as primarily a professional home for ACT
researchers and practitioners, although related therapies like FAP have
been tolerated but not similarly promoted (e.g., there is no menu tab
for “FAP” on the ACBS website). Established in 2005, the ACBS
website boasts 9,000 members, with slightly over half outside of the
UnitedStates. ere are 45 ACBS chapters covering many areas of the
world including Canada, Europe, Japan, Brazil, Australia/New
Zealand, Turkey, Malaysia, and more. ere are also over 40 Special
Interest Groups covering a wide range of areas such as children and
adolescents, veteran’s aairs, ACT for Health, etc. e organizational
structure is designed such that the Board maintains tight control over
all committees and activities, and Board meetings are closed.
Black people not well represented in the
organization
At rst glance, it appears that ACBS is a diverse organization,
hailing members and organizational leaders from many countries
around the globe. But on closer inspection, one notes the
BOX 2 Perspective: an Incident of racism in a Black-White FAP trainer dyad.
Following a one‑year engagement in FAP coaching from a noted FAP trainer and author who was a White man, a prospective Black (female) FAP‑trainer was met with a
stunning assertion at the conclusion of her training. One of the issues she worked on with him was her fears of being unlikable, which was a by‑product of her experiences as
a Black woman in America. When the training was over, she took a courageous risk and told the trainer that she would like to remain friends. His response to her was both
anti‑reinforcing and the antithesis of their work together. Hesaid, “No, youare too much work.” is hurtful response undermined the work she had done in trying to feel
more condent and acceptable to her professional community and ultimately made it even more challenging for her to connect with the next FAP coach she had to work with,
who was also White.
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overrepresentation of White members, despite the international
celebration, with some Asian inclusion, and little to no representation
of Black people, Indigenous people, or non‑White Hispanics. ere
are 9 members of the Board of ACBS for 2021–2022; 8 are White, 1 is
Asian, and none are Black, with roughly the same pattern repeated
from the inception of the organization in 2005. Every year there are 8
White people and one POC, where the POC is typically Asian and
oen a non‑voting student member. ere are no ACBS board
members of color who are not Asian. ere has never been a
non‑White president. ere is no true democratic process in the
election of Board members as an election committee chooses the two
candidates that are able to have a run‑o for each vacancy. Although
the membership votes on the two choices selected by the committee,
the rationale behind the choice of candidates is not made public. For
the most recent voting cycle (2022), all candidates are White. It seems
clear that Black people have been excluded from ACBS leadership, and
Hispanic people have been critically underrepresented as well, and the
organization is structured such that the membership has little power
to rectify the problem.
e rst associate editor of color at Journal of Contextual
Behavioral Science (JCBS; also not Black, rather East Asian), was an
ethnically Japanese person; aer a long pause the next was a Southeast
Asian and former student Board member only appointed recently. e
rst Black plenary speaker was Janet Helms who in 2019, spoke about
Whiteness – much needed for the largely White audience but clearly
not intended for attendees of color. Even so, one Black psychologist
who was present was brought to tears, overwhelmed by nally seeing
a Black psychologist honored on stage.
JCBS, the scholarly outlet for ACBS and related work, is a
top‑ranked journal, with an impact factor of 3.1. e journal has one
editor‑in‑chief, 14 associate editors, 66 editorial board members, 3
student editors, and a professional ocer. A review of the website
reveals only a single Black person, who is on the editorial board. is
means that 1.2% of the JCBS editorial board is Black, despite Black
people being 12% of the US population. is is a 10x
underrepresentation. More disturbingly, it is unclear the extent of
involvement in ACBS of the lone Black editorial board member. is
board member has a single paper published in the journal from 2015
(about body image in White women) and has not been in recent ACBS
conference materials as a presenter. is could appear as tokenizing,
which occurs when someone is included for the appearance of
inclusion and not actually recognized for their contributions or a
member of the group in a meaningful way (Williams etal., 2021d).
ese numbers of non‑White people involved in JCBS are in line with
reports and observations of poor attendance of people of color at
ACBS conferences.
ACBS has a diversity and inclusion committee, however the
structure of this body is dierent from similar professional boards. All
actions must bevetted by or framed as suggestions for the Board and,
in line with our previous observations about how policy can
be weaponized, the Board’s decision‑making processes are not
transparent. e diversity committee does not get a vote or seat on the
Board, and they are not permitted to attend board meetings. ere has
been little Black representation on this committee and only in the last
few years have Black voices been included (there are currently 2 Black
members). e committee has observed the Whiteness of featured
speakers, mistreatment of the lone Black plenary speaker, and the
shunning of Black voices at ABCS. Structurally, this committee is
powerless and exists only in an advisory capacity. It is not a party to
the decision‑making process nor to why or how decisions are made
about the very topic it was called into existence to remedy. It cannot
remedy these problems and its voice is generally ignored by the Board.
e lack of transparency in Board decisions, lack of power sharing
with committees and members, and rigidity is consistent with White
supremacist power hoarding in organizational structures (Okun
etal., 2019).
Lack of support noted by members
In December of 2015, the ACBS published the results of a
Diversity Survey Report on its website. No similar survey has been
done since the writing of this paper, however the results from 2015 are
informative. is anonymous survey went out to the entire 7,200
members on ACBS as well as 1,700 members of ACT and 680
members of RFT listservs (Afari et al., 2015). About 10% (709)
members responded, and of these, 541 had complete responses to
every question. A total of 537 responders indicated their race/ethnicity
with about 80% (428) identifying as White. e results do not indicate
how many of the remaining 20% indicated “Black,” as the POC were
lumped together into a single monolithic entity.
Although only 10% of the ACBS membership responded, the
demographics are similar to what was known of the ACBS
membership at the time, with a greater female to male ratio (approx.
60/40) predominantly White, US based (50%) and English speaking,
with more than 50% of respondents working in clinical settings.
e report added a caveat in regard to the applicability of the
ndings to “minority groups” with the statement, “the majority of the
respondents who gave us input about inclusivity are not necessarily
diverse.” So, it is through this lens that the results should beinterpreted.
Nonetheless, the results of the survey do have something to say about
the perception of its members about how the ACBS community is
treating its non‑White members. ese can beseen in responses to the
following questions.
ACBS asked if its community provides a supportive environment
for racial and ethnic minorities. Although 70% of respondents agreed
that the community was supportive of them personally, less than 40%
“agreed or somewhat agreed that the community was supportive of
non‑English speakers, members with disabilities, nurses, physicians,
those working in non‑MH settings, and ethnic and racial minorities.”
We nd this to bea staggeringly low number. is indicates that
although members (mostly White) felt supported, they were able to
observe how the most vulnerable members were not. e spread
between 70% and “less than” 40% is damning, especially considering
that research shows that people in positions of privilege are less likely
to notice the suering of those less fortunate (Stellar etal., 2012). In a
follow‑up question, respondents specically indicated that cultural
diversity needed to beincreased and those groups who are poorly
supported and the areas of diversity which needed more work are
Cultural, Professional and Socioeconomic diversity.
We would like to focus on the way in which the report
characterized the results of the 73 comments focusing on how ACBS
is not supportive of its members, who described how their experiences
were demotivating and unhelpful. e report notes, “Prominent
unsupportive experiences included predominating male gender,
non‑transparent organization, lack of cultural/developmental
Faber et al. 10.3389/fpsyg.2023.1217833
Frontiers in Psychology 12 frontiersin.org
adaptation, predominance of English, inaccessible events, and
perceived micro‑aggression.” No other category was prefaced by
“perceived” therefore this can beread as an indication that the writers
did not believe that the microaggressions were relevant or real (or
were required to use this wording to placate White leadership). Here,
wewould like to make the implicit racism in this phrase explicit.
Notably, this report is freely available online, and Black Americans
who may beinterested in learning more about diversity issues as they
relate to ACBS, perhaps for the purpose of joining the organization,
may read this page, understand this wording to bea coded threat, and
reconsider their involvement.
Finally, when asked how ACBS could improve support for
diversity, 81 comments made suggestions which included:
Encouraging more participation for new and diverse members,
improving supervision, mentorship, and consultation for members
supporting local events, and aordability as well as promoting
professional diversity. Aer 8 years, there is no visible follow‑up on
how any of these suggestions may have been implemented, despite the
existence of a diversity committee. e ACBS leadership understood
the gravity of this feedback, but, to‑date, there is no public sign of
committed action on this front, and no further studies. e afore‑
described White supermajority Board is the body with the power to
order a follow‑up or make the changes advanced in the survey.
Recently, ACBS leadership produced a report of the ACBS Task
Force on the strategies and tactics of CBS research, and made 33
recommendations (Hayes etal., 2021). ere was very little mention
of diversity issues, although Recommendation 24 stated: “CBS
research needs to address diversity issues (gender; language; race,
ethnicity; sexual orientation and identity, etc.) in treatment and
process of change research,” with a warning about bias and noting that
diversity variables need to be“thoroughly considered” (p.180). But
these recommendations rang hollow in light of the orphaned 2015
survey, a historically super‑majority White board, and the absence of
any acknowledgement of the human suering caused by racism or
other forms of oppression and marginalization, even within ACBS.
In our investigation, wedid learn that in the aermath of George
Floyd’s extra‑judicial murder and the subsequent global racial
reckoning, there were shis in the climate at ACBS that made more
space for Black inclusion due to what one Black member described as
“White guilt.” For example, there is a new set of clinicians of color
brought in by members of the diversity committee through MEND, a
group of trauma experts focused on healing communities of color
1
using ACT. ey had better experiences because the ACBS diversity
committee and the related special interest group found ways to make
them feel welcome, such as having a social event for people of color at
a recent conference. ere has been some thought and action around
these issues, although members feel there is still a very long way to go
in making ACBS truly inclusive.
Is ACT relevant across races?
In a misguided attempt to showcase the diversity of ACT
research, Steve Hayes (2015) posted an article on the ACBS
1 www.mendminds.org
website (listed third on Google with search terms “ACT therapy
Black”) with the headline “Does ACT work for minorities or the
poor?” The webpage and even the title is offensive, and full of
implicit bias. The wording implies that racial “minorities” and the
“the poor” are comparable groups that can belumped together as
if they are the same. Most Black people in the US are not poor
and would beoffended to bestereotyped in this way. What kind
of statement would it make to have a page titled “Does ACT work
in White People or the entitled?” or “Does ACT work for Asian
People and math geeks?” Here wewould like to make the implicit,
explicit, and point out pathological stereotypes that stigmatize
non‑White groups. Further, the inclusion on the webpage of a
study carried in SouthAfrica on the majority population shows
a confusion about the difference between race, ethnicity and
culture. Efficacy in a majority Black, culturally and ethnically
South‑African population does not automatically mean that it
will have efficacy in an American Black population – any more
than in an ethnically Han Chinese or Indian Sri‑Lankan
population. Black people who are trying to learn more about
ACBS will read this page and discern that this is not a safe
professional home for them.
To better understand the human toll that results from racial bias,
it is important to share and analyze some recent experiences that Black
people have encountered within the organization. ACBS missed an
important opportunity to provide allyship and support in a report of
misconduct involving ACBS leaders (Box 3). White researchers
published data collected by a Black researcher without the person’s
consent or any acknowledgement in a contested but now published
work appearing in JCBS.
This paper was the result of a collaboration between several
senior primary investigators and their graduate students on a
project to develop a new scale for which they agreed to share
authorship. The project was set up by the investigators so that the
data collected at the Black researcher’s institution would flow
straight into the data collection survey system at the university
of a White lead researcher.
This authorship dispossession (Box 3) represents another
example of how systemically applied weaponized policies can
favor White individuals in power at the expense of a minoritized
person (Gaertner and Dovidio, 2008; Okun et al., 2019;
McFarling, 2021). Following a complaint to the journal, the
contested article was put on hold, but the researcher was told it
had to beresolved through university channels, with no help
from ACBS or their ethics committee and no appreciation for the
power dynamics that make it unlikely for Black persons to prevail
in such disputes (Williams, 2019; Dupree and Kraus, 2022). The
Black scholar had no university resources to resolve the dispute
since the data was collected at their former university and they
had been hired, but not yet started, at a new university. Absurdly,
due to these demands, the scholar was forced to file a complaint
with the perpetrators’ university to stall the process. In this
example of policy weaponization, because they had no rules for
such a situation, JCBS created ad hoc arbitrary rules which
required that the researchers appeal to their universities.
However, it is impossible to appeal to a resource that youdo not
possess. The editors used their own indifference and the ambiguity
of the situation to allow a discriminatory outcome. This is
aversive behavior weaponized into a policy because it allows a
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Frontiers in Psychology 13 frontiersin.org
racist outcome on the institutional level while maintaining
plausible deniability for the organization (McGillicuddy‑De Lisi
etal., 2006; Okun etal., 2019; Faber etal., 2023b) and uses arm’s
length injustice to withhold organizational resources that could
have made a difference (Okun etal., 2019; Chen etal., 2021). The
incident was never reviewed or judged by an ethics or diversity
committee or other impartial body. In any dispute, the institution
having an interest in the outcome cannot also bethe judge. As
such, in a Kafkaeske process, JCBS ultimately published the paper
based on the judgment of a White complaints officer at the
university of the perpetrator without representation or a hearing
for the Black researcher. As such, the data was published
against their will, without acknowledgement or apology, and the
journal washed their hands of the whole incident. A White
lead author went on to use the data in his thesis, also
without permission.
This type of issue is not an isolated incident in our field. One
recent article listing multiple similar incidents to the one in Box 3
explains how the failure of White scholars to acknowledge the
contribution of people of color is “intellectually dishonest and
echoes a history of White people in power refusing to credit Black
scholars and activists for their work” (McFarling, 2021). There is
a well‑documented failure to credit scholars of color, and more
than enough evidence to show that publication and
citation practices reproduce this institutional racism (Avery
etal., 2022).
Most White people in the US and other Western nations have
both explicit and implicit pro‑White, anti‑Black biases (Faber
et al., 2019; Harjunen et al., 2021; Gran‑Ruaz et al., 2022).
Research shows us that White people will rarely advocate for
Black people in the presence of other White people, even if this
means operating against their own values (Williams etal., 2021c).
Research and experience also show us that because overt racism
is stigmatized, it is unlikely that the aforementioned persons are
aware of the role of racism in their decision making (Williams
etal., 2022). Furthermore, White solidarity will require a very
high burden of proof, question over and over if racist events
really happened, and look for non‑racial explanations for the
cause of the conflict (McGillicuddy‑De Lisi etal., 2006). Persons
confronted about these incidents will profess that they did not
intend for the outcome to appear racially discriminatory although
the outcome is racially discriminatory. Racism, however, does not
require intent to harm people of color. Experiences such as these
alert Black people and their networks to the level of care and
allyship they can expect from the CBS community and contribute
to low numbers of Black people in ACBS.
ACBS and the illusion of inclusion
In an attempt to address issues such as these, the ACBS diversity
committee was excited to invite an accomplished Black psychology
professor to join the committee in 2019. is candidate has been a part
of many organizational diversity committees in other organizations
and was a founder of the Diversity Advisory Council for another large
professional association. She is routinely asked to serve on diversity
committees for organizations, even ones where she has not
been involved.
Based on all objective criteria, such a prolific and influential
scholar would bea top candidate for inclusion, however, the
Board of ACBS rejected the recommendations of their own
diversity committee. The justification provided to the candidate
was that she had not been a member of ACBS long enough or
been to enough conferences to be considered for committee
membership. Yet the scholar had fulfilled all of ACBS’ specific
internal qualifications for expertise in this field including a
standing‑room only talk at ACBS own conference, served as a
grant reviewer for ACBS own grants, was a peer‑reviewer for
JCBS (ACBS own journal), organized an ACT (ACBS own
therapy) training at Yale, and was lead author on an edited
volume with New Harbinger (ACBS own publisher) about mental
health equity from a CBS perspective. The rejection is consistent
with the aforementioned policy weaponization, where unclear
standards disadvantage the qualifications of Black people,
regardless of how accomplished they might bedue to stereotypes
of inadequacy or aggression. This negative experience left the
rejected Black scholar feeling further alienated from the
organization, so she stopped attending conferences and eventually
dropped her membership. This helped to maintain the White
power imbalance by preventing a strong person of color from
having even a small leadership role in the organization as it
threatened the status quo.
BOX 3 Perspective: an incident of racism against a Black scholar and ACBS member.
In this incident, a Black researcher was reassured that aer the data was collected they could beincluded as an author. A lead author had said by email, “ere’s room for many
authors as wewant to becollaborative.” e Black scholar however, was shocked to later see the nished paper “in press” at JCBS. Despite intensive involvement and collecting
a third of the data for the paper (over 400 subjects), the Black investigator had been completely omitted. White PIs were listed as the rst several authors, followed by a number
of their graduate students and junior colleagues. (To justify the exclusion of the Black scholar as an author, one of the scholar’s former graduate students of color was included
as a ninth author, which is neither customary nor appropriate.)
When queried, the lead White investigator claimed in an email that it never occurred to him that the Black researcher might possess the expertise needed to meaningfully
contribute to the paper – despite that the scholar had over 100 academic publications, including a dozen on psychometrics. e assertion that the scholar was underqualied
is a common racial trope used to excuse exclusionary racist behavior (McDonald, 2021). What is worse is not only was the scholar excluded, but they were also manipulated
into doing free work, which is another problematic racial dynamic whereby Black people are expected to work without fair compensation because their labor carries less value
than labor by White people (Pettit and Ewert, 2009). e Black scholar was understandably distressed by this situation and felt exploited and deceived. Holding the position
of power, the White lead authors refused to meet, compromise, or engage in mediation with the Black scholar for co‑authorship, even though adding the author would not
have harmed the lead authors in any way.
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Frontiers in Psychology 14 frontiersin.org
is experience also underscores how, as aforementioned, the
ACSB diversity committee suers from a lack of power in the
organization, exemplied through its inability to even choose its own
members regardless of their qualications. MIT scholars note that DEI
committees “must be suciently empowered to implement their
initiatives meaningfully and successfully” (RISE MIT, 2020).
Disempowered committees cannot bring about change and are
commonly used by organizations as window dressing to provide the
illusion of inclusion (Okun etal., 2019).
Discussion
Black Americans have highlighted the importance of anti‑
racism education and community driven practices to address the
mental health needs in the Black community. The current authors
contribute to these collective voices and offer to the literature our
reaffirmation of the long‑held position that organizations must
confront racism and address the contemporary and historical
racial paradigms within that affect Black people. Black
communities emphasize that critical self‑reflection at the
individual level and racial equity analysis at the level of the
organization is long overdue (Alang, 2019). The utility of CBS
must beconsidered with these imperatives in mind.
However, this paper demonstrates that CBS has failed to
address the needs of the Black community. This is a result of
individual biases that have been enacted through the research
conducted and the policies and procedures of the organization
dedicated to its advancement. As key examples, the most critical
mental health needs of Black people have been misunderstood
and unaddressed in ACT scholarship, and Black trainees have
experienced barriers to learning FAP due to lack of equity in the
training process. Further, ACBS as an organization has failed to
beinclusive of Black people, and it has failed to act on known
problems underscored in its own investigation. Racially biased
policy structures are left to exist and continue to cause racially
disproportionate harm.
Psychology as a discipline is overwhelmingly White and this
is not an accident (Stewart etal., 2017; Faber etal., 2023b). This
disparity was pointed out in Roberts etal.’s (2020) influential
paper which laid out the evidence that the topics studied, the
editorial decisions, the participants in research, the influencers,
professors and decision makers are overwhelmingly White. This
situation influences every level of psychological science, however
most profoundly, results in a state of self‑deception, an inability
for the beneficiaries of this White‑biased system to impartially
see and quantify the problems, and rose‑colored glasses about the
effects and outcomes of this Whiteness. More succinctly put,
“White people benefit from obscuring the existence of racial
inequality from which they benefit” (Bergkamp et al., 2022;
Dupree and Kraus, 2022, p.271). Pointing out facts like these
generates defensiveness, which functions to deflect attention
from the real issues (Howell etal., 2017; DiAngelo, 2018).
One of the main tasks for anti‑racist advocates is to drag hidden
and covert racism into the light, not so that people can beshamed but
so that problems can beseen and resolved. is is an essential pathway
to healing and reconciliation with non‑White communities. at
which cannot beseen cannot betreated. is mindset is fundamentally
at odds with White supremist structures that benet from racism,
particularly when it remains unacknowledged, stigmatized, or covert
(Okun etal., 2019). As researchers and practitioners, weunderstand
how and why it is not in the best interest of therapists or clients to
allow these ingrained cultural impulses to go unchecked. Without
transparency, Black practitioners and researchers will continue to beat
odds with ACBS.
Further, misconduct and reports of discrimination should
bemonitored and mediated by the ACBS community. It is critical
that some level of protection and oversight is put in place to
remedy the ongoing enactment of racism in its professional
circles. As psychology researchers, senior voices in the field
should bewell‑aware that structural racism remains embedded
in every structure from client care to membership to the
publication process, to review and beready to confront racism as
it arises (Williams, 2019; Dupree and Kraus, 2022). There is no
naturally occurring racial progress. Gains are brought about only
by struggle (Dupree and Kraus, 2022).
It can beexpected that some who read this will rightly assert that
it is easy to point out problems but hard to come up with solutions.
Wedo have a solution, and it can besummarized succinctly as power-
sharing. In Table2, weprovide some practical examples of steps that
can betaken to make CBS spaces more inclusive and equitable. If
ACBS is interested in systemic organizational changes, they can take
note of these anti‑racist steps being taken by many similar professional
organizations, in particular the apology of the APA to People of Color
for their failure to challenge racism within the organization (APA
Council of Representatives, 2021). Notably, other organizations with
similar problems might also implement these solutions
where applicable.
Conclusion
To date, there are no signs that the warning bells of the ACBS 2015
diversity survey have been followed by relevant actions or even a new
survey. Further, there does not seem to beany accountability structure
toward POC in regard to culturally‑informed research, anti‑racist
practice, diversity grants, publishing, certication, or ethical behavior
in psychology as it pertains to executive leadership, decision‑making,
and structural organization. Anti‑racism approaches require an
honest examination of the problems, despite discomfort and without
experiential avoidance.
Existing structures will resist change, and as such
implementing equity will take courage and persistence. This may
beuncomfortable, but within this solution is also where ACT and
FAP principles can behelpful. Those who care to do better can
accept they have been participating in a racist system, accept the
unpleasant feelings that accompany that level of honesty, commit
to becoming anti‑racist allies, and take valued actions to create
equity. They can become more aware of their impact on Black
people, have courage to make a change, and show love by being
better human beings through tangible acts of care (Tsai etal.,
2009; Williams etal., 2022).
Faber et al. 10.3389/fpsyg.2023.1217833
Frontiers in Psychology 15 frontiersin.org
TABLE2 Practical steps for anti-racist organizational transformation.
Governance Revise ACBS organizational bylaws to require 50% of all board and committee seats occupied by people from
marginalized groups (including Black people).
To increase transparency, ACBS can post board minutes on the organizational website (redacted where needed for
condentiality).
Increase the ethnic and racial diversity of the journal’s editorial board composition.
Implement anti‑racist practices in JCBS editorial processes, including appointing designated associate editors with
expertise in diversity issues (as was done by the Association for Behavioral and Cognitive erapies; Sanders etal.,
2022).
Empower the ACBS diversity committee to improve their ability to aect change in the organization (e.g., they appoint
their own members, are provided with a budget and funding for projects, have at least one DEI‑informed board
member who actively participates in the committee, etc.)
Have open and free elections (i.e., rank ordered vote for Board seats and ocers), based on members getting signatures
of other members in support of their candidacy, for example, rather than having candidates hand‑picked by the current
super majority‑White Board.
Hold Annual General Meetings (AGMs) with ACBS members, to allow the Board to report back to the membership
about their progress towards the mission and strategic priorities of the organization, including equity goals, and to
encourage dialogue and discussion within the ACBS community on key issues aecting members.
Anti‑racism and organizational culture change is everyone’s responsibility. Equity and anti‑racism goals should
bewoven into ACBS’s foundational documents, policies, and practices (i.e., how weput our values into practice as a
goal in the strategic plan, reporting on progress in annual reports, developing operational policies that explicitly
reference equity and inclusion as core to the functioning of the organization, etc.) rather than sitting as a stand‑alone
initiative.
Metrics Collect racial, ethnic, and other identity data to quantify disparities at ACBS (membership, grant recipients, conference
attendees, etc.) and beable to create a baseline to track progress moving forward (ABCT Board of Directors, 2021).
Collect racial, ethnic, and other equity seeking data on JCBS editors, reviewers, and authors to ensure equity in
publishing and to track progress moving forward (Else and Perkel, 2022).
Re‑administer the 2015 survey, use it as a springboard for updating Specic, Measurable, Achievable, Realistic, and
Timed (SMART) goals, led by the diversity committee (Bjerke and Renger, 2017).
Research Organize a special issue of JCBS focused on research about non‑White groups (as done by APA and APS; Wolitzky‑
Taylor etal., 2017
;
King, 2021).
Provide annual grants and awards for CBS research focused on people of color and researchers of color (as done by the
American Board of Professional Psychology).
Require all submission to the organization’s journal to include an author positionality statement and sample race and
ethnicity data (with an explanation for non‑diverse samples).
Teaching Organize listening forums where leadership will hear the concerns of Black members to direct change [as was done by
the National Institutes for Mental Health (NIMH; Gordon, 2022)].
Implement annual anti‑racism training for all Board members and those in leadership positions.
Organize a conference focused on issues impacting non‑White groups (i.e., Kouame etal., 2021).
Recon‑ciliation and mitigation Publish a Board statement apologizing for perpetuating racism in psychology, as done by the APA C ouncil of
Representatives (2021), and outline the initiatives being implemented to change the situation.
Task the diversity committee or a DEI consultant with reviewing all rules, policies, practices and procedures to identify
and excise institutional racism and propose updates to ensure the organization has the internal infrastructure needed to
become more equitable.
Reach out to Black people who have le the organization and nd out why they le and what it would take to meet
their needs and beable to return to the ACBS community.
Create a condential process to investigate complaints of discrimination whereby members can choose a liaison or
investigator from their own identity group (Charkoudian and Wayne, 2009).
Provide free ACBS membership to Black and other marginalized people until the organization achieves representative
levels of diversity in its membership.
Add current, useful, and non‑demeaning diversity content to the ACBS website with help from the diversity committee
(as was done by the International OCD Foundation; Gimber, 2020).
Faber et al. 10.3389/fpsyg.2023.1217833
Frontiers in Psychology 16 frontiersin.org
Author contributions
SF and MW contributed primarily to the conception and overall
writing. IM was involved in rening and editing the text as well as adding
commentary on critical events narrated in the text. JT draed the sections
on FAP and ACT as well as checking the references, and CF contributed
to the early dras to the rst half of the paper on the needs of the Black
experience. All authors contributed to the article and approved the
submitted version.
Funding
is research was undertaken, in part, thanks to funding from the
Canada Research Chairs Program, Canadian Institutes of Health
Research (CIHR) grant number 950‑232127 (PI MW) and award
number CRC‑2018‑00239.
Acknowledgments
We thank Mehdi Mahammadi for help with editing and
references and Amy Bartlett for suggestions for promoting
organizational equity. We also thank numerous members of
ACBS who assisted but felt it necessary to remain anonymous to
protect themselves or others.
Conflict of interest
SF is an employee of Angelini Pharma and a partner in Bioville
GmbH. Neither of these aliations have inuenced the content of
this publication.
e remaining authors declare that the research was conducted in
the absence of any commercial or nancial relationships that could
beconstrued as a potential conict of interest.
Publisher’s note
All claims expressed in this article are solely those of the authors
and do not necessarily represent those of their aliated
organizations, or those of the publisher, the editors and the
reviewers. Any product that may be evaluated in this article, or claim
that may be made by its manufacturer, is not guaranteed or endorsed
by the publisher.
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