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Disrupting professional myths about “the mainstream”: Diversity, inclusivity, and bias reduction are paramount in conventional publication standards

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Gávi Ansara, Acting Editor

Acknowledgement of Country

I acknowledge the traditional custodians of the lands from which I am writing, the Boon Wurrung People of the Kulin Nations. I also acknowledge Aboriginal, Torres Strait Islander, South Sea Islander, Māori, Pasifika, and Indigenous Peoples around the world. I acknowledge their enduring sovereignty over lands, waters, knowledge and kinship systems, and community wisdom. I bear witness to the diversity of their lived experiences, their resilience and strength in the face of genocide and colonisation, and their ongoing resistance to racism and systemic oppression. I honour the Elders and Ancestors, whose wisdom endures.

 

About This Issue

As Acting Editor of PACJA, I have been honoured to support the journal through this transitional time. I thank former Editor Rhys Price-Robertson for his many pivotal contributions to the journal and for his gracious support during my time as Acting Editor. I also wish to express my appreciation for the PACFA Research Committee and PACJA’s Editorial Board members.

Articles in this issue showcase diverse methodological approaches and perspectives. PACFA Research Committee members Alexandra Bloch-Atefi, Elizabeth Day, Tristan Snell, and Gina O’Neill document the experience and skill of the PACFA workforce, identify how counsellors and psychotherapists could fill gaps in mental health services in Australia (particularly in regional, rural, and remote areas), and make a compelling case for government recognition of registered counsellors and psychotherapists through Medicare’s Better Access funding. Steven Ng Po Yaip and Ada Chung Yee Lin examine the challenges that university professors in Singapore experienced when referring students to counselling services and provide recommendations for supporting educators to serve as informed sources of counselling referrals. Jane Fowler, John O’Gorman, and Mark Lynch report on the development of the Counselling Skills and Competencies Tool (CSCT), which has the potential to provide useful feedback to beginning counsellors that will improve therapeutic effectiveness. Malini Turner explores how integrating a transpersonal approach in therapeutic practice can improve practitioners’ ability to work with spiritual concerns and experiences. Thomas Mark Edwards explains how the field of semiotics relates to meaning-making in therapeutic relationships and explores five semiotic practices that practitioners can use to move beyond a focus on symptoms and diagnoses, toward a deeper engagement with entire sign systems that can provide valuable clinical information. Book Review Editor Kitty Vivekananda assesses a book that explored why some people achieve post-traumatic growth following suffering and loss. Book reviewer Kate Reimer provides a trauma-informed analysis of a book on how virtues can help people to excel in the art of living.

The Shift to APA 7th Edition Publication Standards

Midway through the editorial process for this November issue, the Research Committee and PACFA approved my request for the journal to shift from editorial standards from the 6th edition of the Publication Manual of the American Psychological Association (APA) (2010) to APA 7th edition (2020). Furthermore, although the APA 6th edition already contained a section on reducing bias in language, PACJA had focused on the sections for referencing, paper format, and mechanics of style; with the shift to 7th edition, PACJA will prioritise more consistent adherence to APA recommendations on reducing bias in language.

Bradley et al. (2020) observed that “knowledge is an important aspect of any counselor’s professional life” and that counsellors are “repeatedly confronted with the need to obtain counseling information” (p. 126), often through reading professional journals. The authors contended that all relationship and family therapists “should be familiar with the APA Publication Manual” (p. 126), because these guidelines reflect basic standards for reading and writing about professional practice. The increased attention to diversity, inclusivity, and reducing bias in language in the PACJA editorial process is congruent with this approach.

During the process of integrating the new 7th edition publication standards, I was surprised to learn that even some senior scholars are unaware this long-established section of the Publication Manual exists and that they do not consider bias reduction in scholarly communications to be a “mainstream” concern. Given that APA guidelines are the most widely adopted publication standards in the social and behavioural sciences worldwide (Hughes et al., 2010; Madigan et al., 1995), referring to bias-reducing guidelines as “not mainstream” is an inaccurate and insidious mischaracterisation. In this editorial, I aim to raise reader awareness that reducing bias in language has been, and continues to be, a conventional and essential component of ethical professional communications. I also make the case that we as professionals must be willing to adapt to meet current and emerging standards for reducing bias.

Why APA Standards Matter

APA Style, sometimes called “APA Format”, is the most widely used standard for professional communications among researchers, practitioners, educators, and students in the social and behavioural sciences (Hughes et al., 2010). APA Style is the standard for writing in the counselling profession (Bradley et al., 2020). In addition, APA Style has become ubiquitous in the fields of nursing and education and is recognised in English composition textbooks (Madigan et al., 1995). APA Style might also have some strategic potential for Aboriginal and Torres Strait Islander healing practitioners, to the extent that APA Style grants professional recognition and credibility within a mental health sector built around colonising practices and dominated by English-speaking, Anglo Australian norms.

APA Style addresses all aspects of professional communication and manuscript preparation, with particular emphasis on publication ethics and standards. APA provides nuanced guidelines for word choices that reduce bias in language. The APA Publication Manual both promotes and reflects disciplinary norms, to such an extent that it has been critiqued and lauded as both a “bible” (Walsh-Bowers, 1999; Landrine & Klonoff, 1999) and as a form of epistemology (Madigan et al., 1995; see also Teo, 2008, for a discussion of epistemic violence in negative constructions of the “Other” in psychological research). Critiques of these standards have contributed to advances in subsequent editions (e.g., Ansara & Hegarty, 2012, 2014, 2016; APA, 1977; Gannon et al., 1992; Hegarty & Buechel, 2006). However, as Russo (1999) explained, additional measures beyond these critiques have been necessary to reduce sexist bias in research contexts and processes (e.g., Denmark et al., 1988; McHugh et al., 1986; and Stark-Adamec & Kimball, 1984).

Some approaches to the philosophy of science recognise the societal, political, and economic contexts within which science occurs. This values-based science prioritises accountability, social engagement, and social responsibility (e.g., Buchanan et al., 2021; Buchanan & Wiklund, 2020; Kourany, 2010; Rogers-Sirin, 2017). APA publication standards matter, because they both reflect and determine how we as professionals conceptualise, communicate about, and behave toward people who participate in therapy and research with us.

An Abridged History of Diversity, Inclusivity, and Bias Reduction in APA Standards

APA was founded in 1892 and initiated its journal publication program during the 1920s (Madigan et al., 1995; VandenBos, 1992). In late 1928, the Conference of Editors and Business Managers of Anthropological and Psychological Periodicals met in Washington, D.C., under the auspices of the Division of Anthropology and Psychology of the National Research Council. During this meeting, the Conference adopted guidelines that were published as a seven-page report in The Psychological Bulletin in 1929 (Bentley et al., 1929; see Sigal & Pettit, 2012, for a detailed historical account of the origins of the APA Publication Manual). This report provided the first standardised instructions regarding how to prepare English language manuscripts for publication in social and behavioural science periodicals. The content focused on the general form of manuscripts (i.e., length, physical characteristics, headings, etc.), the subdivision and articulation of topics, references and footnotes, and tabular matter and illustrations.

These instructions contained a notable diatribe that seems almost comedically acerbic today. It might seem surprisingly harsh and insulting to contemporary readers:

The writer who is incompetent in spelling, grammar, or syntax should seek help. Authors presenting scientific articles for publication are expected to be literate and self-critical. They should not be surprised or resentful when careless and illiterate manuscripts are declined and returned. A badly prepared manuscript always suggests uncritical research and slovenly thinking (p. 58, lines 8-14, emphasis added).

This rousing glimpse into early publication standards for articles considered “scientific” documented the centrality of self-critique and critical thinking to publication standards as far back as the late 1920s. Although the concept of critical thinking in psychological literature has often centred on purely methodological concerns, Yanchar et al. (2008) noted the need for authors to critically examine the scientific analytic foundations on which research is based. According to Yanchar et al., focusing solely on methodological concerns “prohibits sufficiently critical analysis of theory and research” (p. 265); they stressed the need to perpetually reassess and revise conceptions of critical thinking to address the evolving needs of the field.

Content relevant to APA’s publication standards for reducing bias in language dates back over 40 years. The first standalone edition of the Publication Manual was published in 1952 as a supplement to the Psychological Bulletin (APA Council of Editors, 1952; see Hughes et al., 2010). The section on reducing bias in language itself originated during the 1970s, when feminist scholars critiqued existing APA publication standards (e.g., APA Task Force on Issues of Sexual Bias in Graduate Education, 1975). These critiques were later published in APA’s Guidelines for Nonsexist Language in APA Journals (APA, 1977), which formed the original basis for the section on reducing language bias. Russo (1999) described the history behind the development of the section on reducing bias in language, a history that was conspicuously absent from past editions of the Publication Manual. Russo also explained the importance of diversity and inclusivity in editorial hiring decisions and other factors that can affect the adoption and implementation of guidelines for reducing bias. Russo’s critique remains relevant. For example, Buchanan and Wiklund (2020) explained the need to prioritise diversity, social justice, and intersectionality in clinical work, theory, teaching, training, supervision, and research contexts. Buchanan et al.’s (2021) Diversity Accountability Index for Journals (DAI-J) provides 25 benchmarks for addressing racism in psychological science and establishing accountability for issues of diversity, inclusivity, and bias reduction in peer-reviewed journals.

By 1983, two new sections (pp. 43-49) were added to the Publication Manual (APA, 1983): Guidelines for Nonsexist Language in APA Journals, which was developed from the standalone document critiquing the inadequate coverage of this issue in previous editions (APA, 1977) and similar critiques, and Avoiding Ethnic Bias. The 3rd edition marked the first time that dedicated sections on reducing bias in language had been formally included in the Publication Manual. In the 4th edition, APA (1994) guidelines challenged over 100 years of convention in the field of psychology by advising researchers to describe people who participate in research as participants” rather than “subjects”. In this 4th edition, APA recommended that authors acknowledge research participation and avoid impersonal terms that construct the experience as something researchers do to people (see Danziger, 1990, for a historical account of this shift). Willis and Letourneau (2018) noted that the Publication Manual prioritised “respecting the dignity and inherent worth of all persons”, a principle which “is at the heart of codes of ethics across the helping professions” (p. 481). As highlighted by Willis and Letourneau, the 6th edition had already advised authors to “call people what they prefer to be called” and warned that, if a label is perceived as pejorative, it “should not be used in any form” (APA, 2010, p. 72).

Some Advances in APA 7th Edition Guidelines for Reducing Bias in Language

The 7th edition of the Publication Manual provides more comprehensive and intersectional recommendations for reducing bias in language than any previous edition, with an entire chapter devoted to this topic. Chapter 5 of the 428-page print edition (APA, 2020, pp. 131-152) and the Bias-Free Language webpages in the online Style and Grammar Guidelines (APA, 2021a) contain guidelines for reducing bias when writing about people in general, as well as specific sections to address characteristics such as age, disability, neurodiversity, gender, sexuality, research participation, racialised and cultural identities, socioeconomic status, and intersectionality.

The latest guidelines for reducing bias in language in the Publication Manual were developed by six APA committees of scholars in each area (APA, 2020). APA explains on the Bias-Free Language section of their website that

The American Psychological Association emphasizes the need to talk about all people with inclusivity and respect. Writers using APA Style must strive to use language that is free of bias and avoid perpetuating prejudicial beliefs or demeaning attitudes in their writing. Just as you have learned to check what you write for spelling, grammar, and wordiness, practice reading your work for bias (APA, 2019).

APA explicitly treats “reading your work for bias” as pivotal and fundamental. It is clear from APA’s own description of APA Style that reducing bias is a core aim in professional communications.

The 7th edition prioritises the general principle of acknowledging people’s humanity in an eponymous sub-section. Willis and Letourneau (2018) explored the shift in 6th edition standards toward using person-first language, in cases where this formulation more closely aligns with how people prefer to be described: “person with schizophrenia” in place of the pejorative “schizophrenic”, and “person with an intellectual disability” in place of ableist phrases such as “mentally handicapped” (p. 482). According to these standards, adjectives should not be used as singular or collective nouns, unless they reflect how people describe themselves. Instead, APA recommends the use of person-first language with descriptive phrases, especially when discussing stigmatised lived experiences or health-related symptoms (e.g., “people experiencing financial hardship”, not “the poor”; “people who use alcohol and other drugs”, not “alcoholics” or “drug users”; “people who are incarcerated”, not “prisoners”; and “people experiencing homelessness” or “people in transitional housing”, not “the homeless”).

The 7th edition contains valuable information about how professionals can communicate about sexuality in a respectful and inclusive way. Although some of the recommended language in this section needs to be adapted to integrate regional variations in political histories and terminology, the APA recommendations are intended to challenge discrimination and support legal protections on the basis of sexuality. For example, “sexuality” and “sexualities” are the preferred terms used by many scholars around the world, whereas APA’s use of “sexual orientation” terminology reflects how the “immutability” trait has been used in anti-discrimination efforts for “sexual orientation” in US legal advocacy (see Diamond & Rosky, 2016, for a critical analysis of this issue). The section on sexuality acknowledges the distinction between sexual and emotional attraction. In this section, APA affirms the legitimacy of asexual and aromantic lived experiences and identities, with specific recognition for terms such as demisexual and gray-asexual (APA also mentions the abbreviated form of this term, gray-A). This section explains that sexuality “may be described by individuals using a multitude of descriptive self-identification labels”, including but not limited to lesbian, gay, straight, bisexual, queer, pansexual, omnisexual, “and many others” (APA, 2021b). APA cautions authors to avoid the term “homosexuality”, due to its association with “negative stereotypes, pathology, and the reduction of people’s identities to their sexual behavior” (APA, 2020, Section 5.8). For similar reasons, APA considers the term “homosexual” to be biased language, unless a specific person self-identifies using this term. As APA advises, due to the evolving nature of terminology in this area, “self-identification is best when possible” (APA, 2020, Section 5.8).

The gender section reflects growing international consensus on respectful and inclusive practices to prevent sexist and cisgenderist language. Such language can negatively impact women and men of cisgender and transgender experience, non-binary people, and people whose lived experiences and identities include other forms of gender diversity around the world. Gender identities such as genderqueer, gender-fluid, and agender (non-gendered) are explicitly recognised. Authors are advised to avoid terminology and research practices that assume gender is always binary and that assume participants are of cisgender experience unless otherwise specified. APA recommends that authors provide an option for participants to self-report whether they are trans. While recognising that some people self-identify as trans people, APA suggests that researchers should also provide options for people who identify as simply women or men (not as trans women or trans men) to have their trans history or lived experience recognised.

The 7th edition discourages unnecessary use of gender-related terms that refer to biological sex characteristics. Instead, APA recommends using terminology about gender (e.g., woman, man, non-binary, etc.) rather than terms that describe biological sex classifications (e.g., female, intersex, male) in contexts where gender is the more appropriate and relevant variable; this is the case in most psychotherapy and counselling contexts. APA also reminds authors not to use language such as “birth sex”, “natal sex”, and other terms that are considered disparaging. As in previous editions, APA considers the terms “opposite gender” and “opposite sex” to be sexist language, because there are more similarities than differences between genders and sexes; terms such as “another gender” or “another sex” can be substituted. This section also contains some guidance on describing people’s relationships, explicitly acknowledging people in polyamorous relationships and noting that less biased terms such as “mixed gender” or “mixed sex” should be used to describe partners with different genders or sexes.

APA alerts authors that “pronoun usage requires specificity and care on the author’s part” (APA, 2020, Section 5.5). This section also dissuades authors from using terms such as “preferred pronouns”, as this term implies that people’s pronouns are a matter of personal choice rather than reflecting their understanding of themselves; suggested terms are “identified pronouns”, “self-identified pronouns”, or simply “pronouns”. APA discusses a range of legitimate pronoun options, acknowledging “many others”, in addition to the singular “they”, “ze,” “xe,” “hir,” “per,” “ve,” “ey,” and the Swedish gender-neutral pronoun “hen” (APA, 2020, Section 5.5). APA acknowledges that people may alternate between pronouns or prefer to be described using their name instead of any pronouns. APA explains: “Refer to a transgender person using language appropriate to the person’s gender, regardless of sex assigned at birth—for example, use the pronouns ‘he,’ ‘him,’ and ‘his’ in reference to a transgender man who indicates use of these pronouns” (APA, 2020, Section 5.5). APA provides clear guidance about how to report on participant gender demographics in an inclusive way, a section with which researchers are advised to become familiar. Noble et al. (2021) praised these beneficial changes and provided resources to assist professionals with the process of adopting less biased language to describe people’s gender and sexuality lived experiences.

The Racial and Ethnic Identity section articulates that “race is a social construct that is not universal, so one must be careful not to impose racial labels on ethnic groups” (APA, 2020, Section 5.7). Consistent with guidance in the other sections of the Publication Manual, this section recommends using the terms people use to describe themselves whenever possible. When making inter-group comparisons, APA instructs authors referring to marginalised racial and ethnic groups to use “underrepresented groups” rather than “minorities”; APA explains that the use of “minority” may be viewed pejoratively because it is usually equated with being less than, oppressed, or deficient in comparison with an assumed majority. APA directs authors to capitalise “Indigenous” and “Aboriginal”. APA details some forms of diversity that are often overlooked in journal articles, providing detailed sub-sections on describing people of African, Asian, European, Latinx, and Middle Eastern descent. For example, APA explains that “some American people of African ancestry prefer ‘Black,’ and others prefer ‘African American’; both terms are acceptable. However, ‘African American’ should not be used as an umbrella term for people of African ancestry worldwide because it obscures other ethnicities or national origins, such as Nigerian, Kenyan, Jamaican, or Bahamian” (APA, 2020, Section 5.7). In another example, the Indigenous Peoples Around the World sub-section includes Aotearoa/New Zealand and Australia. APA clarifies that the correct spelling of “Māori” or “the Māori people” uses the diacritical macron over the “a”, mentions variation in terms used by Aboriginal and Torres Strait Islander Peoples, and instructs authors to “refer to specific groups when people use these terms to refer to themselves (e.g., Anangu Pitjantjatjara, Arrernte)” (APA, 2020, Section 5.7).

In the 7th edition, APA acknowledges the evolving diversity in linguistic preferences related to disability and neurodiversity. The 7th edition recognises that some groups intentionally capitalise their identity to promote unity and community, such as the Deaf community. APA notes that, although some people consider lowercase “deaf” inappropriate, not all people with hearing loss identify as Deaf. APA accepts that autistic people often prefer to be described using identity-first language instead of person-first language (e.g., “autistic person”, not “person with autism”), and that, depending on the context, either or both types of language could be appropriate. To determine which language to use, APA encourages professionals to “use the label that the community uses, even when that label is adjectival” (APA, 2020, Section 5.2). APA confirms that matters of style (e.g., referencing, paper format, and mechanics of style) are less important than people’s own preferred language, specifying that “language should be selected with the understanding that the expressed preference of people with disabilities regarding identification supersedes matters of style” (APA, 2020, Section 5.4, emphasis added; see Dunn & Andrews, 2015, for further guidance). As APA explains, “honoring the preference of the group is not only a sign of professional awareness and respect for any disability group but also a way to offer solidarity” (APA, 2020, Section 5.4). APA further encourages authors who are not sure which language participants prefer to “seek guidance from self-advocacy groups or other stakeholders specific to a group of people” or, when working directly with participants, “use the language they use to describe themselves.” In other words, in the event of a conflict between bias reduction and matters of style, APA considers diversity, inclusivity, and bias reduction superior in importance to all other issues discussed in the Publication Manual.

Conclusion

Although I have provided only partial coverage of the 7th edition content on reducing bias in language, I hope this glimpse into the nuance and complexity of Chapter 5 encourages readers to learn more. Like its precursors, APA’s 7th edition affirms explicitly that ongoing attention to emerging issues of diversity, inclusivity, and bias reduction in professional communications is essential to maintaining our professional ethics. In this edition, APA also confirms that reducing bias in language takes precedence over all other matters.

In an editorial published in the peer-reviewed SAGE journal Sexual Abuse (Willis & Letourneau, 2018), Gwenda Willis and Elizabeth Letourneau discussed changes reflected in the 6th edition of the Publication Manual (APA, 2010) and acknowledged that “some once popular labels” used to describe people with disabilities and psychiatric diagnoses “now seem almost unutterable” (p. 482). When articulating the shifts that had not yet occurred within the fields of forensic/correctional psychology and criminology to comply with APA 6th edition (2010) standards, Willis and Letourneau (2018) noted their belief that “similar change is both achievable and overdue in correctional/forensic psychology and related fields” and this kind of change “requires some time, effort, and thoughtfulness” (p. 482). The authors expressed confidence that professionals would “move quickly and proficiently to implement this recommendation” (p. 482). I have similar confidence in you, dear readers, that our professional community can make the changes needed to join with this international and collective effort to adopt the recommendations in the 7th edition of the Publication Manual. Respecting the dignity and inherent worth of all people—particularly those to whom mental health professions have historically denied this respect—is not only conventional but imperative to the preservation of our professional ethics.

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