Training competent counselors for everyBODY : the impact of a health at every size training on weight bias and its relationship to multicultural competence

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Brittany Putnam Gerringer (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:
Kelly Wester

Abstract: Weight discrimination, the maltreatment of individuals perceived to have larger sized bodies driven by both implicit and explicit biases about weight, is a growing issue in society with deleterious effects for individuals of size (Andreyeva et al., 2008; Hatzenbuehler et al., 2009; Puhl & King, 2013; Swift et al., 2013; Tomiyama, 2014). Despite having training in multicultural competence which provides ways for counselors to gain awareness of biases and skills to work with clients who differ from them, unfortunately, counselors are not immune to weight biases impacting their counseling work, with counselors demonstrating comparable (and unfortunately high) amounts of weight bias as other professionals (Akoury et al., 2019; Puhl et al., 2014). Strong weight bias is also evident in counselors-in-training (CITs), who tend to characterize higher weight clients as having significantly more negative characteristics and significantly lower work efficacy than lower weight clients (Pascal, 2011), and ascribe a poorer prognosis to clients of size (Adams, 2008). Therefore a critical time to address weight stigma is in the training of new counselors and mental health professionals, before harm can be perpetuated in their work. The Health at Every Size (HAES) paradigm presents a paradigm shift from the historical view that higher body weight is a disease to be treated, by instead positing that all bodies are good bodies deserving of care and respect regardless of size, that weight loss is not inherently a means to increasing health, and advocates to decrease weight discrimination instead of perperuting it (ASDAH: Trademark Guidelines, 2003). While there have been studies on the efficacy of non-HAES aligned weight stigma trainings to decrease implicit and explicit biases in mental health trainees (Cravens et al., 2016; Pratt et al., 2016) and some studies in the efficacy of HAES-aligned weight stigma trainings in college students and dietetics students (Brown, 2009; Humphrey et al., 2015; Rosalez et al., 2015), to date, there have not been studies on how a HAES-aligned weight-stigma training tailored for CITs impacts implicit and explicit weight bias. The present study utilized a quantitative two-group crossover quasi experimental design to examine how a HAES-informed training on weight stigma will impact CITs’ implicit and explicit weight bias, and HAES competence, and how multicultural competence is related to change in both implicit and explicit weight bias. A total of 55 counselors in training participated in the study, 32 in the treatment group and 23 in the delayed intervention group. The data was analyzed using repeated measures ANOVAs to explore the changes in pre-post bias scores and a correlation analysis to explore the relationship between multicultural competence on bias change. Results of the study indicated small but not statistically significant changes in implicit bias and significant decrease in explicit bias, though due to a high amount of missing data concrete interpretation is cautioned. The results also indicated a significant increase in HAES competence after the training and a nonsignificant relationship between multicultural competence and bias change. This study provides an important next step in moving the counseling field forward in terms of better preparing counselors to provide a space of healing and support for all clients, regardless of their body size.

Additional Information

Language: English
Date: 2022
Bias reduction, Counselor education, Health At Every Size, Weight bias, Weight stigma
Discrimination in mental health services
Discrimination against overweight persons
Physical-appearance-based bias
Counselor trainees

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