Macy Wilson, M.A.June 7th, 2016

“All I Really Want is Peace of Mind”: Understanding the Experiences and Working with the Strengths of Black Male Youth

› Some my [homies] got years of they life took from them, and I just wanna see all of mine, About half of my [homies] they not even here – pour a four up, it keep me from crying

› Doin shows made me miss Grandma birthday this year, who I don’t even see all the time, Tryin to balance out family and my career, All I really want is peace of mind…

› I’m so deep in the streets, know some secrets I won’t ever tell that could get me some time, Seen so much in my life, I got demons in me, I don’t fight I just keep em inside

› My whole family pray I stay safe everyday, they be checking on me all the time, And I swear man I hate seeing tears on their face, keep two hammers on me all the time

› ‘Why it gotta be my life at risk everyday?’ type of sh*t that I think all the time

Peace of Mind – G Herbo (Lil Herb)

“Perceived [and anticipated] racial discrimination has been found to be negatively correlated with cardiovascular health, psychological well-being, and self-esteem, & positively correlated with hostility, somatic complaints, anxiety, and depression” (West, Donovan, and Roemer, 2010).-Hope, et al., 2016; Hudson, et al., 2016

› Provides clients with opportunities to access services that are reflective of their lived experiences.

› Provides culturally-congruent approaches to presenting problems.

› Provides a greater sense of safety for the client.› Reinforces the idea that culture is essential to healing.› Increases access to care and improves assessment,

treatment planning, and placement.› Enhances effective communication, reinforces and

empowers the client’s self-advocacy.

Why is Cultural Competence Important?

› What it is:– Culturally-congruent administrative practices (top-down).

› What does this look like?– Policies, procedures, programming, staffing, community involvement (p.

76)– Regularly engaging in self-reflection/exploration of cultural

identity and awareness; knowing your own biases and working to eradicate them.

– Doing your own research and not expecting the client to use therapy time to educate you.

– Respect for, validation of, andopenness to all of the client’s experiences.

(SAMHSA, 2015)

Defining Cultural Competence

› What it ain’t:– Assuming that you already know the struggles of a client,

based on physical presentation or previous notes.– Generalizing treatment approaches for all clients.– Hiring people of color solely to achieve “diversity.”

› “Increasing diversity does not guarantee culturally responsive practices” (SAMHSA, 2015, p. 8).

Defining Cultural Competence (cont’d)

› Economic disparities (Smith, 2007; Hudson, et al., 2016)– Black women make $0.63 for every $1 made by white men (AAUW,

2014).› Food deserts› Racism

– At school, at work, in other areas of the community› Inaccessibility and scarcity of resources

– Reliable transportation › Quality of Care (SAMHSA, 2015)› Unequal Education› School to Prison Pipeline

Some Systemic Barriers in the African-American Community

› Adolescence– Independence– Self-image

› “Black youths must develop positive physical self-esteem in a society that sexualizes them regardless of gender and defines physical attractiveness as something that they are not” (Nicolas, et al., 2008).

– Sexuality– Peer relationships– Educational/vocational goals

Additional Struggles

› Exaggerated fight-or-flight response› Cardiovascular reactivity› Elevated nocturnal blood pressure levels and poorer

sleep quality› “Racial discrimination is related to depression, suicide,

violence, stress disorders and maladaptive coping strategies, such as substance use, among African-Americans” (Hope, et al., 2016).

› Physical violence as a coping mechanism– Quote from Menducation, “They take advantage of how you act,

if you’re not dominant.”

What’s Race Got to do With it?

› At a glance:– Bipolar Disorder– Attention Deficit/Hyperactivity Disorder– Conduct Disorder or “Antisocial Tendencies”– Oppositional Defiant Disorder– Intermittent Explosive Disorder

› Upon Closer Inspection– Major Depressive Disorder– Other Specified Trauma- and Stressor- Related Disorder– Post Traumatic Stress Disorder– Reactive Attachment Disorder– Adjustment Disorder

Common Diagnoses

Socioecological PerspectiveUnjust society: economic, social, cultural, and intellectual

oppressionMental illness is fundamentally rooted in large-scale social injustice.

Cognitive PerspectivePerceptual processing, internalized racism, locus of control

Family Stress ModelPoor economic conditions parental psychopathology and poor

parenting increased risk for C&A psychopathologyBiopsychosocial Perspective

Biological, psychological, and social aspects

Etiology of Major Depressive Disorder in Black Youth (Hammock, 2003)

Strengths evolve from racial socialization (cultural resources) and are used to cope with general and racial barriers to healthy development (p. 264).

Nicolas, et al., 2008

› 200 African-American Youth (ages 14-18) – 100 from the community and 100 from juvenile detention centers

› Self-report measures to assess racial respect and racial socialization, along with demographic surveys– Survey of African-American Male Youth Experience and

Behavior (current study)– 45-item Scale of Racial Socialization–Adolescent Version

(SORS-A) developed by Stevenson (1993, 1994a) for use with Black youth

– 20-item African-American Respect Scale (current study)– 7-item Use of Violence Scale DuRant et al. (1994)

Racial Respect and Racial Socialization as Protective Factors… DeGruy, et al., 2012

Racial Socialization: the process of transmitting rules, regulations, skills, values, history, and knowledge about culture and race relations from one generation to another.

Racial Respect: a prosocial attitude that arises from the recognition of one’s inherent self-worth, the honoring of one’s racial origins by the self, peers, and others in society, and an appreciation of the contributions made by oneself, one’s family, and African Americans as a group.

Degruy, et al., 2012

Racial socialization may serve to deter young people from the use of overt aggression, by providing grounding in Africentric values.

› Withdrawal› Resilience› Resistance

– Truth – Skills– Critical Thinking

Typical Coping Strategies for Black Youth Dealing with Barriers

› More formally known as“sociopolitical consciousness.”

› Issues of oppression, cultural significance, and the nuances of self-identity struggles may not be as easily verbalized by youth.

› It is the responsibility of the therapist to “stay woke” and assess for the ways in which oppressive circumstances are affecting the youth.

You woke, or nah?

› Selfobjects– ..As cultural productions, the self and cultural selfobjects are unique to

the context in which development, needs, and care occur…Kohut assumed cultural selfobjects to be sources of self cohesion brought about via the engagement with cultural productions such as art, important figures, literature, music, and so on. Thus, he held that cultural selfobjects served to facilitate self cohesion for the individual and for groups. (Sheppard, 2011).

› Appreciating their lived experiences of struggle.› Modeling effectance

– Present alternative prosocial ways of dealing with disrespect› Encourage youth to speak about their identity struggles.› Staying woke! (do your own research!)

Implications for Therapy

American Association of University Women (AAUW). 2014. Economic justice. Retrieved from http://www.aauw.org/2015/07/21/black-women-pay-gap/DeGruy, J., Kjellstrand, J.M., Briggs, H.E., & Brennan, E.M. (2012). Racial respect and racial socialization as protective factors for African American youth. Journal of Black Psychology, 38(4), 395-420.Hammack, P.L. (2003). Toward a unified theory of depression among urban African American youth: Integrating socioecologic, cognitive, family stress, and biopsychosocial perspectives. Journal of Black Psychology, 29(2), 187-209.Hope, E.C., Hoggard, L.S., & Thomas, A. (2016). Becoming an adult in the face of racism. Monitor on Psychology, 47(6), 35-38.Hudson, D.L., Neighbors, H.W., Geronimus, A.T., & Jackson, J.S. (2016). Racial discrimination, John Henryism, and depression among African Americans. Journal of Black Psychology, 42(3), 221-243.Nicolas, G., Helms, J.E., Jernigan, M.M., Sass, T., Skrzypek, A., & DeSilva, A.M. (2008). A conceptual framework for understanding the strengths of Black youths. Journal of Black Psychology, 34(3), 261-280.Sheppard, P.I. (2011). Self, culture, and other in Womanist practical theology. New York, NY: Palgrave Macmillan.Substance Abuse and Mental Health Services Administration (SAMHSA). (2015). Improving cultural competence. Rockville, MD: U.S. Department of Health and Human Services.West, L.M., Donovan, R.A., & Roemer, L. (2010). Coping with racism: What works and doesn’t work for Black women? Journal of Black Psychology, 36(3), 331-349.Wilson, D., Foster, J., Anderson, S., & Mance, G. (2009). Racial socialization’s moderating effect between poverty stress and psychological symptoms for African American youth. Journal of Black Psychology, 35(1), 102-124.

References