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Adolescent Psychiatry

Editor-in-Chief

ISSN (Print): 2210-6766
ISSN (Online): 2210-6774

Perspective

Clinical Considerations in Working with Children and Adolescents of Color: Past, Present, and Future

Author(s): Eunice Yuen*, Susan Daily, Julie Sadhu, Janet Baek, Gabrielle Shapiro, Cynthia Pfeffer, Jonathan Dowben, Kamilah Jackson, Barry Sarvet and Dorothy Stubbe

Volume 14, Issue 1, 2024

Published on: 04 October, 2023

Page: [3 - 8] Pages: 6

DOI: 10.2174/2210676613666230901125251

Price: $65

Abstract

Background: Systemic racism and health inequality for Children and Adolescents of Color (CAoC) and their families need to be acknowledged and addressed in the provision of mental health treatment by child and adolescent psychiatrists. The lack of parity for behavioral health drives the lack of integration of “mental” health with overall health and the lack of funding, policy, planning, and practices to support the social and emotional health of children and their families. Additionally, the unequal treatment faced by Black, Indigenous, and People of Color (BIPOC) children and their families further impacts their overall health and mental health outcomes. Implicit biases, conscious and unconscious, influence clinical judgments, lead to errors in diagnostic and treatment decisions and impair child and adolescent psychiatrists’ ability to fully partner with families to treat, advocate for, and improve the clinical and life trajectories of this diverse group of young people and families that child and adolescent psychiatrists are called to serve.

Methods: Using a case vignette, this paper discusses historical examples showing how child and adolescent psychiatrists’ implicit bias may manifest when working with CAoC. Medical training and clinical practice have paid scant attention to the broader impacts of systemic racism and inequities in healthcare until recent years.

Discussion: This article provides clinical recommendations for clinicians to navigate these factors through trauma-centered and patient-centered care. Viewing through the lens of intergenerational racial trauma and acknowledging one’s own bias, clinicians can better help and support CAoC as they strive toward a brighter future.

« Previous
Fadus, M.C., Ginsburg, K.R., Sobowale, K., Halliday-Boykins, C.A., Bryant, B.E., Gray, K.M., Squeglia, L.M. (2020). Unconscious bias and the diagnosis of disruptive behavior disorders and ADHD in African American and Hispanic youth. Acad. Psychiatry, 44(1), 95-102.

[http://dx.doi.org/10.1007/s40596-019-01127-6] [PMID: 31713075]
Londono Tobon, A., Flores, J.M., Taylor, J.H., Johnson, I., Landeros-Weisenberger, A., Aboiralor, O., Avila-Quintero, V.J., Bloch, M.H. (2021). Racial implicit associations in psychiatric diagnosis, treatment, and compliance expectations. Acad. Psychiatry, 45(1), 23-33.

[http://dx.doi.org/10.1007/s40596-020-01370-2] [PMID: 33438155]
Mandell, D.S., Listerud, J., Levy, S., Pinto-Martin, J.A. (2002). Race differences in the age at diagnosis among medicaid-eligible children with autism. J. Am. Acad. Child Adolesc. Psychiatry, 41(12), 1447-1453.

[http://dx.doi.org/10.1097/00004583-200212000-00016] [PMID: 12447031]
Metzger, I.W., Anderson, R.E., Are, F., Ritchwood, T. (2021). Healing interpersonal and racial trauma: Integrating racial socialization into trauma-focused cognitive behavioral therapy for African American youth. Child Maltreat., 26(1), 17-27.

[http://dx.doi.org/10.1177/1077559520921457] [PMID: 32367729]
Murray, K.J., Sullivan, K.M., Lent, M.C., Chaplo, S.D., Tunno, A.M. (2019). Promoting trauma-informed parenting of children in out-of-home care: An effectiveness study of the resource parent curriculum. Psychol. Serv., 16(1), 162-169.

[http://dx.doi.org/10.1037/ser0000324] [PMID: 30714809]
Pierce, C.M. (1970). Black psychiatry one year after Miami. J. Natl. Med. Assoc., 62(6), 471-473.
Pumariega, A.J., Rothe, E., Mian, A., Carlisle, L., Toppelberg, C., Harris, T., Gogineni, R.R., Webb, S., Smith, J. American Academy of Child and Adolescent Psychiatry (AACAP) Committee on Quality Issues (CQI). (2013). Practice parameter for cultural competence in child and adolescent psychiatric practice. J. Am. Acad. Child Adolesc. Psychiatry, 52(10), 1101-1115.

[http://dx.doi.org/10.1016/j.jaac.2013.06.019] [PMID: 24074479]
Sexton, J.B., Adair, K.C., Proulx, J., Profit, J., Cui, X., Bae, J., Frankel, A. (2022). Emotional exhaustion among US health care workers before and during the COVID-19 pandemic, 2019-2021. JAMA Netw. Open, 5(9), e2232748-e2232748.

[http://dx.doi.org/10.1001/jamanetworkopen.2022.32748] [PMID: 36129705]
Stoute, B. J. (2020). Racism: A challenge for the therapeutic dyad. Am J Psychotherapy 1, 73(3), 69-71.

[http://dx.doi.org/10.1176/appi.psychotherapy.20200043]
Summers, M. (2010). “Suitable care of the African when afflicted with insanity”: Race, madness, and social order in comparative perspective. Bull. Hist. Med., 84(1), 58-91.

[http://dx.doi.org/10.1353/bhm.0.0320] [PMID: 20632733]
Voisin, D.R., Kim, D., Takahashi, L., Morotta, P., Bocanegra, K. (2017). Involvement in the juvenile justice system for African American adolescents: Examining associations with behavioral health problems. J. Soc. Serv. Res., 43(1), 129-140.

[http://dx.doi.org/10.1080/01488376.2016.1239596] [PMID: 28966415]
Williams, M.T., Holmes, S., Zare, M., Haeny, A., Faber, S. (2022). An evidence-based approach for treating stress and trauma due to racism. Cogn. Behav. Pract.

[http://dx.doi.org/10.1016/j.cbpra.2022.07.001]
Yuen, E., Sadhu, J., Pfeffer, C., Sarvet, B., Daily, R.S., Dowben, J., Jackson, K., Schowalter, J., Shapiro, T., Stubbe, D. (2020). Accentuate the positive: Strengths-based therapy for adolescents. Adolesc. Psychiatry, 10(3), 166-171.

[http://dx.doi.org/10.2174/2210676610666200225105529] [PMID: 33859924]

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