ABSTRACT
This chapter introduces a clinical tool that was developed using intersectionality and structural competency frameworks and designed to help people cope with the negative effects of multiple oppressions. Mental health providers can help clients address the psychological, physiological, and social effects of structural injustices. To help clinicians conceptualize the relationship between individual-level interventions and structural racism, the psychiatrist and social scientist Jonathan Metzl introduced the notion of structural competency. Therapists are uniquely positioned to help trans and gender-nonconforming clients of color regulate their emotional responses, thereby mitigating stress, which is one of the factors that links structural-level racism to individual health outcomes. The tool should be used in the context of a strong therapeutic alliance that supports collaboration and open communication. The tool can be useful, not just for emotional regulation between sessions, but also as a starting point for in-session therapeutic metacommunication, or here-and-now explorations that help the client and therapist develop a mutual understanding of the therapeutic relationship.
