The document discusses culturally congruent mental health services for Black youth. It outlines the benefits of such an approach, including greater safety, empowerment, and access to care for clients. Key stressors for Black youth are discussed, such as racial discrimination, economic barriers, and negative societal messages about identity. The author advocates understanding issues in a socioecological context and emphasizing youth strengths like racial socialization and resilience developed through coping with obstacles. Therapists should appreciate clients' lived experiences, model prosocial skills, and facilitate exploration of identity development and sociopolitical awareness.

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

2. › 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

3. “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

5. › 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.

6. › 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, and
openness to all of the client’s
experiences.
(SAMHSA, 2015)

7. › 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).

8. › 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

9. › 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

10. › 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.”

11. › 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

12. Socioecological Perspective
Unjust society: economic, social, cultural, and intellectual oppression
Mental illness is fundamentally rooted in large-scale social injustice.
Cognitive Perspective
Perceptual processing, internalized racism, locus of control
Family Stress Model
Poor economic conditions  parental psychopathology and poor
parenting  increased risk for C&A psychopathology
Biopsychosocial Perspective
Biological, psychological, and social aspects

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

14. › 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)

15. 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.
Racial socialization may serve to deter young people from the use of overt aggression, by providing grounding in
Africentric values.

16. › Withdrawal
› Resilience
› Resistance
– Truth
– Skills
– Critical Thinking

17. › 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.

18. › 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!)

19. 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.