Chapter 42. The Traumatic Impact of Racism and Discrimination on Young People and How to Talk About It 307 4/17/20 11:28 AM

●● e W

ogether, ogether, T ●● society…. society…. will come after us awill come belong to each belong to other. other. just and equitable egardless of race and of race egardless r that that the generations of youth of youth the generations aspire for better, and work and work better, for aspire beyond race, we must want must want we race, beyond what is right for each other, other, each for is right what for greater if we are to leave leave to are if we greater for Our early trauma of and adverse recognition 1 centered on exposure to traumatic experiences exposure and adversity on primarily centered 2 42 Introduction Why This This Matters Why Discrimination is a trauma itself, one that hurts that one deeply. Discrimination is a trauma itself, „„ „„ HAPTER C within the home, such as various forms of abuse and neglect and exposure to household stressors. Emerging such as various to household stressors. forms of abuse and neglect and exposure within the home, occurring childhood exposures outside “Expanded ACEs”—stressful that however, science has established, emotional, which include experiences of discrimination—exertphysical, effectson similar negative the home, childhood experiences (ACEs) Sadly, trauma is a universal experience that occurs in every community, in all economic strata, and within strata, in all economic experience trauma a universal is that occurs in every community, Sadly, It does not discriminate. every group. demographic This chapter describes the pervasive on effectsracism of negative their health and well-being, as on as well development, youth who families and communities and the toll on it exacts the topic of Approaching been raciallyhave marginalized. concern, It can generate empathy, not be easy. racism may as it can as much stir defensiveness, and compassion that lie along and a wide host of reactions hostility, anger, racism differently each approach We this continuum. and self-awareness experiences, to our lived according in our stratified and position critical consciousness, us to bring our most requires racism Approaching society. to suspend emotional and mindful selves, compassionate can open to viewing so that we reactivity world remain the that we and to remember from of others, the perspectives especially crucial in these times This chapter, to each other. belong regardless of who we shoes, all ourselves invites of us to put into other’s of heightened social division, to recognize come our habits of may we In so doing, from. come we or where our individual origins, are, of what to a deeper understanding and come the ways discover to heal, our pillars find of strength, harm, to each other. Because belong we it means to care for another. one Maria Veronica Svetaz, MD, MPH, FSAHM, FAAFP MPH, FSAHM, FAAFP MD, Svetaz, Veronica Maria FSAHM MPH, FAAP, MD, Coyne-Beasley, Tamera FSAHM MPH, FAAP, MD, Trent, Maria MPH, MSHP PhD, MD, Jr, Wade Roy MS, LPC Ryan, Michael Howard MA MSW, ScD, Michele Kelley, FSAHM FAAP, MS Ed, Chulani, MD, Veenod The Traumatic Impact of of Impact Traumatic The on and Discrimination Racism to Talk and How People Young It About RT2e_Sect06_Ch42_307-328.indd 307 RT2e_Sect06_Ch42_307-328.indd 308

SECTION 6. WORKING WITH ADOLESCENTS WHO HAVE ENDURED TRAUMA AND MARGINALIZATION 308 may result in missed opportunities to prevent and intervene withyouth andfamiliesexposedtotoxic stress.may toprevent result andintervene inmissedopportunities ACEs,the original narrowly defined withinthehousehold onadverse theoriginal only experiences focusing (See Chapter 36,(See The Impact of Trauma on Development and Well-being,for more on toxic stress.) aspects ofidentity. tension anddeliver toxic ofstress levels orbuildresilience andotherstrengths. spheres, influences, andexposures thatsurround develop.youth asthey forcescaneither These create etched intooursubconscious.etched mediatedacts butalsoembeddedintoourinstitutions,personally interactions, disguisedinourdaily and motivatedhatetoday,of racially racismcontinuesoursociety. topermeate seenthrough Itisnotonly and thecolonizationofindigenous people. acts condemn overt we andwidely readily recognize While presented inBox 42.1. is humanity through affects adversity thepathways which thatdescribes an overarching framework groups who have historically experienced discrimination. experienced groups whohave historically tion, amplifiedamongfor communities individualsand implications andisespecially hassignificant impact ofdiscrimination, racism, including sexism, misogyny, homophobia, andreligious- discrimina identities: age, gender, sexualorientation, socialclass, andreligion, among others. The cumulative Beyond race, we are multidimensional beingswhoselives reflect theintersections ofourmany social depends on socialinteraction andsupport. theirdevelopmental growth because Children todiscrimination vulnerable andadolescents are especially I 2. by respondents ACEs. thantheoriginal violence,munity neighborhoods, livinginunsafe were andracialdiscrimination) more endorsed commonly thatexpandedACEsers found (stressful exposuresoutsidethehome, childhood occurring ascom such - emphysema, diabetes, fractures). Inareplication oftheACE among adults inPhiladelphia, Study research- stress disorder) healthconditions andphysical (ie, disease, cardiovascular autoimmune disorders, cancer, health problems, mentalhealthconditions (substanceuse, including depression, anxiety, andpost-traumatic ofabuse, exposure forms between childhood tovarious neglect, adult andhouseholdstressors for andrisk ACE (Adverse Study, ChildhoodExperiences) publishedin1998, demonstratedagraded relationship isassociatedwithsuboptimaloutcomeschildhood adversity across course. thelife Significant Thesentinel M 1. and socialhealththroughout course. thelife of theparent’s environment. conceived. Epigenetics hashelpedusunderstandthatone’s DNA may be altered dependingon thestress compassion toourselves.” withawiseheart.ship withhumanity incompassion,wrapped character havingmoral This includes better,for is arelation- everyone inwhich “in care, of Kingdefinesasaculture andtocultivatewhatRuth andaboutyouth.of uswhocarefor bia, expressions andovert of racismofrecent times, urgentthose needfor addressing racism isacritically have historically experienced oppression. experienced have historically health outcomes. s an easur R A „„ Racism has long been a part ofhumanhistory. haslongRacism beenapart At itsextremes, genocide, thishasincluded slavery, Children different ofthecolortheirskin. andyouth distinctly realities because experience Throughoutchapter, this call on all, we race of andbeyondrace,regardless for other, towant toaspire and Racism inCurrentand Racism Times Key Concepts to Highlight About Teen Development acism dverse Childhood E xpanded ed U 9 Given that 14%ofstudyrespondents endorsedexposure to theexpandedACEs andnot ndermines 12 Identitiesare inavacuum but, notformed rather, thedifferent are shapedfrom A 8 C 4 E 6 Racism is trauma that affects all our all thataffects youth, istrauma Racism youth ofcolorwho especially anda E D xperienc e 3 Also, expandedACEs were strongly associatedwithpooradult velopment and S 7 Considering thetideofnationalism, Considering ethnocentrism, xenopho- 10,11 ocial 3 Infact, have animpact before can even anindividualis they One of the many tasks of adolescence is to establish critical Oneofthemany tasksofadolescence istoestablishcritical es D et A re erminant of 5 A model that integrates discrimination into discrimination Amodelthatintegrates B r oader W ell-being: T han H ealth 13 I R nitially acism acism

3

4/17/20 11:28 AM Chapter 42. The Traumatic Impact of Racism and Discrimination on Young People and How to Talk About It 309 4/17/20 11:28 AM We . ,” affects “Expanded ACEs Thus, having an ecological lens is We must see people as they deserve to be seen and take affects every community but affects African American, Native American, and affects every community but affects African . communities in astoundingly higher proportions have exposure to the trauma that comes from navigating a world with implicit biases and all have exposure to the trauma that comes ngs, it is hard to escape. i t t gainst those living in poverty. Once they are born into poverty, whether in urban or rural poverty. Once they are born into poverty, gainst those living in oung lives. Poverty is an ACE and a powerful social determinant. Classism is a group bias an ACE and a powerful social determinant. oung lives. Poverty is e of color disproportionally. For example, family breakdown that comes from communities of color disproportionally. For example, family incarceration socioeconomic status, children and adolescents of Regardless of exposure to other ACEs or their color Latinx vital when supporting youth. structural forces that perpetuate inequities. This means that while any child can be exposed to structural forces that perpetuate inequities. force of discrimination and the low expectations suffering, the intersectionality of the added our attention associated with implicit biases mean that we need to be intentional about focusing on these negative forces and their impact. amygdala“) as well as endocrine “brilliant The science of trauma reveals that neural circuitry (the to many of milieu (eg, increased cortisol level) associated with the need to be hypervigilant leads This strongly suggests that while explicit the harmful biological results associated with trauma. hatred is toxic, so, too, are the ever-present and undermining forces of implicit biases, of color to microaggressions, and structural racism, because they force underrepresented people navigate the world with a constant state of vigilance. exposure, we Just as we recognize the challenges that people have suffered because of trauma people who must simultaneously recognize all their strengths, including their resilience. Many have the hardest lives also possess the deepest levels of compassion and unwavering commitment to lifting others up. great care not to apply labels to them related only to the hardships they have endured external must celebrate with them all the things that they have conquered despite these strengths as forces and start coaching them to recognize their own experiences and relational successes. a s Suffering is tragically a theme of the human condition. It has no demographic nor color. It has no demographic of the human condition. tragically a theme Suffering is a lack of the nurturant to trauma or from suffer from exposure and adolescents When children brains, and behaviors. adults, it may affect their bodies, protective force of connected must focus on basic survival issues. adult stress is magnified, and they In low-resource contexts, and may interfere with adults prevalence of trauma-inducing circumstances This may increase the nurturant, secure relationships and time to fill their vital role in creating having internal resources focus to get to the root of the we must have an intergenerational with their children. Therefore, problem. health, and well-being of have a pervasive effect on the development, Social determinants y of structural racism, our contexts. However, because of forces There are many low-resource from inequitable distribution of resources. In other communities of color are more likely to suffer when you belong to these communities and is words, the likelihood of being poor is higher most of these structural forces over and over caused by biases within our systems. Historically, so the effects of historical trauma need to be considered, again affected the same families of color, as a risk factor and as a source of resiliency. acknowledging that our communities of color are We must recognize this while simultaneously protective forces that come from their group identity: often more likely to offer children critical neighborhood-based supports. These strengths must extended families, nurturing cultures, and resilience and needs to be incorporated into any be recognized and magnified. Culture develops positive youth development model. abuse, neglect, substance use, mental illness, The traditional household-based ACEs of community. Similarly, adversity outside of homes and and family breakdown exist within every also called embedded within low-resource communities, 8. 9. 2. 3. 4. 5. 6. 7. 1. 10. Embedded within the framework are the following assumptions: the following are within the framework Embedded Abbreviation: ACE, adverse childhood experience. adverse ACE, Abbreviation: Box 42.1 Trauma Has No Color, and Discrimination Is Another Trauma to Bear to Trauma Another Is and Discrimination Color, Has No Trauma 42.1 Box RT2e_Sect06_Ch42_307-328.indd 309 RT2e_Sect06_Ch42_307-328.indd 310

SECTION 6. WORKING WITH ADOLESCENTS WHO HAVE ENDURED TRAUMA AND MARGINALIZATION 310 We must tobuildajust, strive inclusive, leave toouryouth. proudly we can andequitablesociety—one socialidentities. intheface along ofmarked thelinesofmarginalized inequitiesanddisparities especially groups insociety. present anurgent needto These demographic shifts address and bias, discrimination Beyond race, diverse ethnic, ofindividualsfrom greater there visibility isnotably sexual, andreligious diverse generation byracially far. Ofthatsegment, 48%are diverse orbiracial, 39%in2002. upfrom who represents ourcurrent 6-to20-year-old segmentofthepopulation, tobethemost ison track health inequitiesare andongoingofdifferential treatment. products experience ofthehistorical of disproportionate impactsofhealthon ofsocialdeterminants communities ofcolorandpresent-day disadvantage ofinstitutionalized andtheirsequelae. history and youth theirfamily inherit The persistence created themremain inplace, ofdisadvantage present-day creating for aplurality generations. Children that mechanisms even asthestructural transmitted trauma are intergenerationally ofhistorical The effects W 3. health anddevelopment, through there discrimination anintersectional isaneedtoview framework. development processes andtheiroutcomes. To ofhowharms effect discrimination understandthefull truly interactions that,create intricate underabroad influences, range ofsocio-ecological affectadolescents’ immigration status, orsocioeconomic status. These multiple socialidentitiesare notmerely additive but a person ofcolorisinfluenced by one’s othersocialidentities, as such gender, sexuality, oforigin, country Youth are multidimensional beings. ofbeing highlightshowThe concept theexperience ofintersectionality A 6. tolerance racism, racial discrimination, xenophobia, andrelated intheface intolerance ofthistroubling trend. movements, andgroups. of forms for The United called renewed actionNations againstcontemporary has globally, motivatedevents increase inracially a sharp ofextremistparties, alongside therise political In recent tonationalism. years, globalization from hasseenasubstantialshift theworld There hasbeen 5. According tothePew Research Center, 4. the following aspects the following attachmenttowardfeelings ofpsychological withand racialidentification aorethnicgroup thatincludes of adolescents’ socialidentities. isamultidimensional thatencompasses identity construct Racial-ethnic development isafundamentaltaskofadolescence,Identity andethnic-racialidentitiesare components key ● ● ● ● ● identity anddevelopment processes.identity For more about theMyVoice information project, seeBox 42.2. and experiences, hasdemonstratedtheprofound impact ofone’s on youth society place inourracialized through youth system which polling soundoff on present-day issues, their voices withthe goal oflifting can be tapped to transform theirlong-termoutcomes. betappedtotransform can Fortunately, theyouth we today intergenerational carefor alsohave strengths inherited andresilience that ● ● ● ● ● pproaches ith Ideology. The content of one’s abouthow one should behave beliefs asagroup member. regard.One’sPublic ofothers’ evaluations ofone’s views group. Private regard. One’s ownofone’s evaluations group. Salience. moment. ataparticular ofidentity The importance Centrality. to one’srace of andethnicity The importance self-definition. T T E A „„ A recent national survey ofyouth aged 14to24yearsA recent through national survey theMyVoice project, atextmessage oday’s Youth here ffectively Culture andIdentity cts of cts D iscrimination A I re n I n A 16 : tergenerational ddressing L iv e inan A re onthe D 15 I GenerationZ(alsoknown asthePostmillennial Generation) iscrimination ncr easingly I mpac R ise ts ofthe D R iverse equir T raumas S es ociety I n tersectional tersectional A ssocia 14 ted ted

5 7

4/17/20 11:28 AM Chapter 42. The Traumatic Impact of Racism and Discrimination on Young People and How to Talk About It 311 4/17/20 11:28 AM w other people view your race affect you? affect race w other people view your This week we want to hear about the role your race/ethnicity plays. race/ethnicity your hear about the role to want we week This ou think you or people your age can deal with negative experiences related to racism? to related experiences age can deal with negative or people your ou think you t do you think MOST people think about your racial/ethnic group? group? racial/ethnic think MOST people think about your t do you e you experienced or witnessed racism? Tell us about it. us about Tell or witnessed racism? experienced e you Hi {{name}}! Wha does ho How Hav do y How

“My race/identity forms a large aspect of my identity because it influences a lot of the treatment that a lot of the treatment it influences aspect identity of my forms a large because “My race/identity associated connotations inevitably negative are there in America, here As woman a black I receive. with or a lack of emotional connection bruteness, Whether it be violence, group. racial with my acknowledged unless blatantly is rarely but it group, racial things about my positive are There others. (17-year-old black girl) emphasized.” (14-year-old I am very though light and pass.” even girl, “It means a lot! I am a very Mexican proud Latina girl) it simply means that I am me, To life. in my role and it does not play a large is white, “My race in face the challenges that those of other races face that I don’t and race my privileged by naturally woman) (22-year-old young white States.” the United and life, my Throughout and half-White. I am half-Japanese me. means a lot to “Race/ethnicity Japan when I only been to I’ve identity. mixed with my trying terms to come to I’m currently[,] even with the Japanese so I feel disconnected pick up the language, able to and wasn’t young really was (18-year-old woman) Asian young of that.” side of me [‘]cause back. spanning thousands of years culture a rich I have me. “My to Chinese heritage means so much (17-year-old girl) Asian American to be Chinese.” I am proud one of the first civilizations. I am from My mom’s the part.’ ‘look I don’t ethnicity emphasis on my because put that much always “I don’t than people assume white so I look more dad is very but my European, American, is Native family those ideals were because background native with my say I identify more I would people are. native work I decide to tribe will dictate where my ties to childhood[,] and my during my emphasized more teen) (16-year-old American Native I will serveand how after that community graduation.” 4. 3. 5. 1. 2. In response to the question “What role does your race and ethnicity play?” teens said, “What to the question In response race and ethnicity does your play?” role MyVoice project is a longitudinal mixed methods study designed to engage youth via text messaging engage youth to methods study designed mixed project is a longitudinal MyVoice Eligible policy concerns. issues or health youth-related reflecton a wide variety timely that of topics at recruited capabilities) are a phone with SMS to access with participantsage, of (14–24 years meet benchmarks based on the to recruited are Youth social media. and through community events online and consented are which they through a website to directed are youth Interested ACS. latest has been developed platform interactive A youth-centered survey. an online demographic complete isconsent Parental to participants.weekly surveys sends confidential and incentives automatically that including academic team, research The because the survey participants. is of minimal risk to not required writing and piloting an iterative through questions develop and youth, methodologists, researchers, and policy makers to researchers, community organizations, from elicited are topics Question process. Weekly be open-ended responses. to developed and elicit narrative are Probes policies. salient inform using descriptive analyzed are data Quantitative data. and qualitative data surveys collect quantitative and traditional quickly language processing are using natural data analyzed Qualitative statistics. supports and analysis in-depth a more integration methods understanding Mixed methods. qualitative a survey to seeking responded youth understand to In 2019, MyVoice March questions. of the research 5 probes: of the following and consisting and perspectives experiences of racism youth Abbreviations: ACS, American Survey; Community ACS, Abbreviations: SMS, short message service. study text national 24 years: message survey aged 14 to of youth MyVoice Moniz MH, et al. Dejonckheere from M, NicholsDerived LP, 2017;6(12):e247. JMIR Res Protocols. protocol. Box 42.2 The MyVoice Project MyVoice The 42.2 Box RT2e_Sect06_Ch42_307-328.indd 311 RT2e_Sect06_Ch42_307-328.indd 312

SECTION 6. WORKING WITH ADOLESCENTS WHO HAVE ENDURED TRAUMA AND MARGINALIZATION 312 In fact, theNational HumanGenome Research Institutereveal thatwhileanindividualmay datafrom no influence on how one fares insociety. racism.race—that one’s insociety— equity theidealwe for shouldthrive Itincludes bears racial identity capital. Table 42.1provides definitions toassist readers acommon indeveloping language asit relates to diversenumbers inourincreasingly society, intheiraccess remaintosocialandpolitical they marginalized racial-ethnic groups thatwere once considered comein increasingly torepresent minorities themajority dimensions relative ofpower andnotracialtraits. anddescribes andprivilege powerlessness While population. We asithighlights nondominantracial-ethnic groups, youth tousetheterm alsochoose from has varied over time and has created a set of values and assumptions toward people from different groups. over timeandhascreatedhas varied asetofvaluesandassumptions toward peoplefrom ofprivilege,tribution resources, andpower infavor ofthedominant racialgroup. that Itisaclassification andcategorize, created isasocialconstruct toclassify Race tocreate hierarchiestoensure anunequaldis- W irageso Common insultsanddegrading messagessent to andderogatory marginalized groups Microaggression Marginalized Ism bias Implicit According to theRobert Wood Johnson Foundation, as isdescribed healthequity Health equity The cultural andviewpoints practices that are presumed to bethemostsignificant and Dominant culture Actions, basedonbiasorprejudice, that benefitoradvance one group over others Diversity Discrimination Bias Ally Advocate T hat „„ erms Throughoutchapter, the terms, we usevarying asyouthcolor such anddiverse of youth,the todescribe Race andRacism white privilege afforded to me by that to dogood.” Jewish young (23-year-old woman) identifier.My race iswhite, whichdoesn’t mean much to mebesidesthe thatIshouldusethe fact isJewish.Thatmy thatIassociate withmy mostimportant ethnicity identity primary “My I s R ace, A ft of the impact oftheirstatements of theimpact oractions) toby thegroup individualsexternal group from (often amajority whomay beunaware Excluded, disregarded, orconsigned to orsociety theperimeter ofacommunity inwhichprejudiceA societalconstruct isaccompanied by systematic power it to enact These biasesare unconscious, althoughtheyresult inunfavorable orfavorable judgments. and housing, safe environments, andhealthcare.” including powerlessness andlackofaccess to goodjobswithfairpay, education quality removing obstaclesto healthsuchaspoverty, discrimination,andthenconsequences, to beashealthy aspossible.“Everyone hasfairandjust opportunity This requires influential inasociety The broad array ofmutualanduniquequalitiesamongindividuals orexclusionunfairness Partiality, conscious orsubconscious prejudice, preference, orfavoritism that results in others whoare discriminated againstand/oroppressed ofanoppressed groupA personwhomay notbeapart whoadvocates withandfor orinaction. caused by action unintentional to harm peopleofcolor andpeoplewhohave beenoppressed, whether work for ofpublicpolicy, theenactment laws, andprograms to address intentional or A personwhostandsupfor oneselfandone’s group identity oracause. Advocates D er efinitions Table 42.1.BiasandOppression Defined A ll? 17 18 6

4/17/20 11:28 AM Chapter 42. The Traumatic Impact of Racism and Discrimination on Young People and How to Talk About It 313 4/17/20 11:28 AM 20,21 19 ) continued roup and the target group are socialized to play their roles their roles play to socialized are group and the target roup 19 roup has the power to define reality for themselves and others. for themselves reality define to has the power roup assment, and discrimination are systematic and institutionalized, so that so that and institutionalized, systematic are and discrimination assment, roups take in and internalize the negative messages about them and end messages the negative take in and internalize roups the individuals are not necessarythe individuals are keep it going. to Genocide, har Genocide, g Members of the oppressor as normal and correct. The oppressor g oppressor The g target The (thinking with the oppressors acting and up cooperating like them). efinitions D Generalized beliefs, biased opinions, and prejudiced expectations about members of and prejudiced biased opinions, beliefs, Generalized certain groups and prejudice, discrimination, exploitation, harassment, and systematic Organized groups inequity affect different that the privilege and harm for people some white by guilt felt or individual collective The racism from resulting 4. Oppression = power + prejudice. = power Oppression ancestry. those of European for white term the group to in contrast United in the groups nonwhite among inclusive be to intended is of color people term The of racism. experiences the common highlighting States, often based on about an individual or group judgment usually negative A biased, stereotypes membership group solely because of conferred or benefit An advantage racial-ethnic in identity and power, based on differences and discrimination Prejudice against people of color. groups descent or European white exerted by and prejudice enact to systematic the power having a group Racism involves the cultural creating institutional policies and practices and by through discrimination racism. reinforce that and values beliefs free fully, and engaging themselves expressing secure in which all feel An environment of attack, or exclusion ridicule, fear from or participation or inhibition of the voice of exclusion or unconscious conscious The particular social groups everyone and respect for fairness, genuine equity, create to Actions intended benefit.” its own for exploits another group whether knowingly or unconsciously, Consequences of the use of structural power and privilege. It and privilege. when one person occurs of structural of the use power Consequences results in Oppression and expense of another. at the disadvantage profits or group dominance. the for powerful a more social group by social group of one subjugation systematic The Rita Hardiman powerfulgroup. political benefit of the more and social economic, social, found: are 4 conditions exists when the following the oppression and Bailey Jackson state 1. 2. 3. Table 42.1. Bias and Oppression Defined ( and Oppression 42.1. Bias Table Race only minimally describes biologically or genetically and is a social and political distinct groups erms Stereotype of System oppression or “White guilt” shame” “white People of colorPeople American heritage, and Native Latin, Asian, of African, adults and youth for term A group Prejudice Privilege Racism space Safe Silencing Social justice Social oppression “[e]xist when one social group, Jackson, social oppressions and Hardiman to According T Oppression have more than 3 million differences in the genome compared with someone else’s, humans share 99.9% of else’s, with someone compared genome in the than 3 million differences more have are known bone structure) hair texture, color, eye skin color, we observeThe differences (eg, the same DNA. which biological do not qualify humans to be distinguished into different people. of races as clines, concept, not a scientific one. To quote Nobel Laureate Toni Morrison on race: is no such thing “There on Morrison race: Toni Nobel To quote Laureate one. not a scientific concept, a social construct, Racism is a anthropologically. is just a human race—scientifically, There None. as race. RT2e_Sect06_Ch42_307-328.indd 313 RT2e_Sect06_Ch42_307-328.indd 314

SECTION 6. WORKING WITH ADOLESCENTS WHO HAVE ENDURED TRAUMA AND MARGINALIZATION 314 tify, acknowledge, and manage ourimplicitbiases. Research showsare thatthey withattention, malleable acts ofrace-based maltreatment inour subconscious.not justovert butlivinginvisibly We must iden- all becoming. It creates unhealthy tensions intheenvironments youth all withinwhich navigatetheirprocesses of humanity. interactions and ourinterpersonal affects relationships andlessensusasapeople. Itnegatively It reduces ourinstitutions, were which on founded thecore valuesofjustice, equity, and respect all for a corrosive force, anddestructive however, peopleofcolor. affect racismdoesnotonly all ofus. Itaffects management recommendations, andpatientoutcomes. of experience, andithasbeenshown toinfluencethepatientexperience, aspain clinician practices such race, present among many healthcare professionals ofdifferent specialties, oftraining, levels andlevels asdelineatedbyaction lens(HEAL) the World theiraspects. intoall HealthOrganization health interventions. Itrequires thecreation ahealthequity ofpoliciesandprocesses thatincorporate andpresent ofsocial, unequaldistribution function ofthehistorical economic, andenvironmental resources. by caused of colorare genetic healthdifferences notsimply butarehealthinequitiesthata systematic disadvantage;as inherited andisembeddedintoourinstitutions. populations affecting Healthdisparities by one’sties ofsociety group. membershipinastigmatized Itisstructural, aswell asnormative; manifests observed disparities across racial categories as socially defined will likely remain. likely definedwill across associally disparities racialcategories observed attention populations tounmetneedsandtheimpacts live, oftheconditions certain underwhich the tounderstand andimprove humanhealth;differences inhumansaneffort however, withoutequal time resulted healthandwellness outcomes. indisparate Now, tremendousfocus is scientific on the0.1% onfocus ourdifferences has resulted inunequal access to resources,freedom, including over andhas construct…. [I]thasasocialfunction, racism.” tounderstandthatthesocietal important Itiscritically rights, recognition, undervalued participation” andundervalued andcreates aculture ofoppression. power diminishsocialinclusion, imbalancesthatcan asittoincomplete citizenship,“leads undervalued sphere negative socio-ecological influencesinthelives andexerts ofpeoplecolor.every Racism creates appearance), (physical according tophenotype heritage, orculture. force thatpermeates Itisapervasive isdefinedasthebeliefs,Racism attitudes,from individualsandgroupscategorizing and actions resulting R Racism existson thatdemonstratehowourexternal,Racism 3levels itpermeates interpersonal, lives. andinternal Levels ofRacism personal commitments to equity and can result in discriminatory behaviors. result andcan indiscriminatory personal commitments toequity are they individuals holdracialbiasesofwhich notaware, held co-occuralongside deeply biasesthat can ofconsciousness. beneathourlevel that operates More ofresearch than4decades hasdemonstrated that or unintentional, acts of commission oromission. and/orvicariously. directly can beexperienced They aggressions (Table acts ofhateand violenceormacroaggressions. 42.2)toovert can beintentional, They cognitive bias; anddiscrimination, micro- bias. or behavioral subtledaily rangefrom can Discrimination stereotypes, assumptions are aboutothersaccording which generalized totheirgroup membershipor and economic health. processes. Policy andprocess solutions are to addressing central inequitiesinphysical, emotional, social, through unequalpolicies. ismaintained This unequaldistribution by inequitablepoliciesandbiased health have alsobeenreferredof distributed toaspoliticalare health,asthey determinantsunevenly of change.ing policy ofhealth. determinants ofhealthare determinants critical Social Social determinants catalyz- thepromisea meansoffulfilling and policies ofhealthinall focusing ourattentionby toequity acism What can we doabout andabout youth, we this?Aspeoplewhocarefor can What racismas thatwe view itiscritical Research shows thatimplicitbiasagainstblack, Hispanic, anddark-skinned individualsis, across doabout we this?Addressing can racismrequiresWhat institutionalized publichealthandpopulation racismisthedifferential access tothe goods, (orstructural) Institutionalized services,- andopportuni Racism also manifests itself covertly asimplicitbias. itselfcovertly alsomanifests Racism ofdiscrimination Implicitbiasisa mechanism Personally enacted racismencompasses 3related aspects: butseparate prejudice, oremotional bias; D efined 26 Such biases exist in every field. biasesexistinevery Such 25 23,24 HEAL is HEAL 6 As 22 4/17/20 11:28 AM Chapter 42. The Traumatic Impact of Racism and Discrimination on Young People and How to Talk About It 315 4/17/20 11:28 AM

In internalized 30 The ADDRESSING tool The ADDRESSING 27 essage M You are not American. are You a foreigner. are You not generally are of color People people. as white as intelligent It of your someone is unusual for be intelligent. to race intelligent people are All Asian and/or in math and talented sciences. ethnic experiences to and/or acculturate Assimilate culture. the dominant extra given are of color People unfair benefits because of their race. lazy are of color and/or People work and need to incompetent harder. culture. dominant to Assimilate The self-system effects model describes the erosive 29 ession icroaggr “You are a credit to your race.” your to a credit are “You so articulate.” are “You help with Asking person to an Asian problem or science a math see color.”“When I don’t you, I look at racial- a person of color’s Denying in this can succeed “Everyone work.” with enough hard society, “Why do you Asking person, a black be so loud [or animated]? to have Just calm down.” “Why person, or Latino an Asian To know to want We so quiet? you are or, think. verbal,” you Bewhat more “Speak up more.” “Where are you from?” “Where you are born?” you “Where were speak good English.” “You M Table 42.2. Examples of Racial 42.2. Examples Microaggressions Table Given that implicit bias is a critical factor contributing to disparities, the framework that implicit bias is a critical Given contributing factor to disparities, is essential 28 Racism is also internalized. of members of stigmatized to the acceptance refers racism Internalized Internalized racism has an internal dimension. heme Ascription of intelligence a to intelligence Assigning of the because person of color race person’s blindness Color a that indicating Statements to person does not want white acknowledge race Myth of meritocracy assertingStatements that in life a role does not play race successes and values cultural Pathologizing styles communication and the values notion that The styles of the communication culture oftendominant, white, ideal are T land own Alien in your Americans and Asian When assumed to Americans are Latino be foreign-born Adapted in part from University of Minnesota School of Public Health website. https://sph.umn.edu/site/docs/hewg/microaggressions. in part of Minnesota University Health website. Adapted from School of Public implications life: in everyday Racial GC, et al. microaggressions Torino CM, Capodilupo 19, 2019, and Sue DW, September Accessed pdf. 2007;62(4):271–286. Am Psychol. clinical practice. for developed by Pamela A. Hays, PhD, provides a framework provides intersecting to help us recognize and explore PhD, Hays, A. Pamela developed by on identity possible influences experiences social identities and the many and the lived development of youth. racism, self-image is negated (physical), self-concept is limited (mental), self-love is defeated (emotional), is defeated self-love (emotional), is limited (mental), self-concept is negated (physical), self-image racism, constantly viewing by It manifests itself in a sense of inferiority, and self-esteem is corrupted (spiritual). to transform or in not taking responsibility power a situation own as a victim and denying one’s oneself questioning, focusing doubting, on Additionally, as a perpetrator role of or colluder with oppression. for one’s intention, and time. With unexamined implicit biases, providers in health care settings can providers contribute to With unexamined implicit biases, and time. intention, inequities as described report in the Institute of Medicine Unequal Treatment. for assessments of the isms that divide society and highlights the importance approaches. of intersectional Internalized can racism be especially about their abilities and intrinsic messages worth. races of negative fundamental task of forming their damaging and developmentally disruptive in light of adolescents’ and I normal?” “Am on the critical identities and reflecting questions individual and group “Who am I?” results in the It strengths. It youth’s can be deeplyyouth and the undermining of a “How do I fit in?” and and potential as an individual strengths, value, to recognize and affirm one’s fundamental failure member of a social group. of internalized racism on individuals—physically, mentally, emotionally, and spiritually. emotionally, mentally, of internalized individuals—physically, racism on RT2e_Sect06_Ch42_307-328.indd 315 RT2e_Sect06_Ch42_307-328.indd 316

SECTION 6. WORKING WITH ADOLESCENTS WHO HAVE ENDURED TRAUMA AND MARGINALIZATION 316 strengths, andpotentialasanindividualmemberofasocialgroup. that undergird thedominating race’s supremacy. group by adopting, supporting, maintaining,from thesetofattitudes, andbenefiting beliefs, andbehaviors whenone oppressedin aracist system theoppression racialgroup supports ofanotheroppressed racial ofeachother’ssupport leadership. Anzaldúa, Gloria Cross-racial coinedby hostility, aterm writer isproduced ofconfidence andalack ingroupresults member’s inadistrust of abilitiesandinthelack acceptance and society. Projecting one’s onto andinadequacy membersofone’s own senseofinferiority group, example, for of peoplecolortomaintainhealthy andfulfilling relationships witheach otherandmembersofwhite their own institutions power inanumberofpossibleways. inwhitemajority–controlled inferior. Conversely, asanger, manifest itcan hostility, behaviorsdirected atwhitepeers. anddiscriminatory relationships withwhitemembersofsociety, asrelating manifest tothemasan racism can internalized behaviorsmany intheirgroup experience. youth alsoemulatebecause ofcolorcan thediscriminatory In andaddress.recognize Personally awhiteon colorphenomenon, enacted isnotsimply discrimination one’s group ofself-doubt. because about threat—theofconfirmingnegative stereotypes risk stereotype itselfinself-defeating also manifests acceptance leaves lesstime, white majority for and striving energy, andresources self-development. for It Youth racismdirectly. experience reflect howracism of shapesthelived experiences youth ofcolor. Youth responses tothequestion you or witnessedracism?”“Have experienced through theMyVoice poll and Racism Youth’s Lived Experiences development). of racial-ethnicidentity Chapter 13, Healthy Adolescent Development, UnderstandingandSupporting adeeperdiscussion for racismtoresilience andthedevelopment ofpositive racial-ethnic self-conceptsand internalized (see different spheres thatsurround youth,from creating stress range can thesummative ofwhich effect from The process development are andoutcomesracial-ethnic influenced ofidentity bymanyforces andIdentity DevelopmentRacism profound effects on exerts Racism youth’s development, identity lived experiences, andlifelonghealth. T internalized racism, address andinstitutional can dimensions.internalized pointthey itsinterpersonal which from theinsideout.proceeds from However, examininganddismantling we must firstassist youth incritically oftheirpresent andtheirfuture andfullness selves possibilities.in therichness oppression Liberationfrom to understanddimensions andpower, ofprivilege prevailingnarratives, tochallenge themselves andtoview consciousness andself-awareness youth thecritical through todevelop support socialization we which can dominant order andpower andcoerces structure orpunishesthosewhodonot. tobesilencedby inplace theprevailing themselves thatrewards thesystem peopleofcolorwhosupport members oftheirown group do, each other’s by notsupporting and power andby allowing authority assuming thatwhitepeopleknow more than aboutwhatneedstobedone theirgroup for society andfor he Internalized racism also has an interpersonal dimension. racismalsohasaninterpersonal Internalized Within the institutional dimension of internalized racism, theinstitutional dimension ofinternalized Within peopleofcolormay question orsubvert What can we doabout inthischapter, we this?Later can What theprocess we describe ofracial-ethnicandpolitical action.” blackyoung man) (21-year-old “Yes, like beingstereotyped[,] often assumptionsthatIonlygotinto Penn State dueto affirmative despite beingasmall, non-threatening, person.” well-dressed young Asian man) (20-year-old seen peoplewalk away from mewhenIhave around my meattimes hoodupandlooknervous skinned, mistaken Iamoften andassuch,Ihave beencalled forbeingblack, a‘n****r.’ Ihave also “Yes, Ihave. Ihave phrases heard peoplesayderogatory aboutIndiansbefore. However, beingdark- E ffects of ffects R acism 31 Itisafundamentalfailure andaffirmone’s nottorecognize value, 32 Cross-racial hostility isaproblem Cross-racial peopleofcolormust hostility 29 Racism can negatively affect the ability theability affect negatively can Racism 29 These include include These 4/17/20 11:28 AM Chapter 42. The Traumatic Impact of Racism and Discrimination on Young People and How to Talk About It 317 4/17/20 11:28 AM “It doesn’t really affect me[,] except to reinforce my own belief that I do not face the challenges that face own belief that I do not my reinforce to affect really me[,] except “It doesn’t woman) (22-year-old young white face.” people of other races “Sometimes it makes me feel a little discouraged, but I remember that my race doesn’t define me— doesn’t race that my but I remember me feel a little discouraged, “Sometimes it makes (15-year-old girl) white I define me.” be their to do anything they didn’t like be white to do anything didn’t we “It bothers me because woman) (19-year-old young white race.” (14-year-old girl) white be.” people can ignorant me sad how “It makes woman) (22-year-old young white us all look bad.” makes “It [racism] for an arbitrary I am often privileged in this world me feel guilty“It because sometimes makes woman) (23-year-old young white skin.” of my the color like reason[,] man) (21-year-old young white history.” me feel sad about racial “It makes “My teacher made fun of my Muslim friend by calling her a terrorist and saying[,] ‘Look, the Arab’s the Arab’s and saying[,] ‘Look, her a terrorist calling Muslim friend by “My made fun of my teacher (16-year-old girl) white out!’” watch angry, ‘ghetto’.” black people are about how remarks and will often make is racist My grandfather “Yes. (16-year-old girl) white ‘Not replied[,] they someone her name, Hispanic and told was girlfriend when I mentioned my “Yes, (16-year-old boy) white gets built anyway.’” out when the wall be kicked she’ll that it matters, TSA Arab and my going through [and] just the other day[,] I was times, many witnessed racism “I’ve (17-year- friend got selected for a secondary him almost every This happens to search. time they fly.” nonbinaryold white teen) “My father is black, and I have seen him experience racism.” (16-year-old biracial girl) (16-year-old biracial racism.” “My is black, seen him experience father I have and after seeing a pardoned almost immediately but [was] pulled over black friend of mine was a “Yes, (16-year-old black boy) friend in the car.” white life being am a quarter I in his professional dad has had trouble and my Hispanic “Yes, woman) (20-year-old young white against.” discriminated “I’m multiracial[,] so I’ve received racism from a lot. Black people won’t accept me because I have I have me because accept won’t a lot. Black people from racism received I’ve so multiracial[,] “I’m (19-year-old black black.” I look me because accept people won’t and white ‘white assets’ people woman) young Chinese.” too White or that I’m I am too and that Chinese enough I am not been told I have “Yes. (17-year-old girl) Asian American And white youth can and privilege. on power and do reflect And white youth youth white you?” race affect“How other people view does how your poll question the MyVoice To their in ways that reflect capacityresponded to critically and privilege. examine the constructs of power Racism also negatively directly. youth affects white Youth experience racism vicariously. Youth experiencesRacism also shapes the lived of color. of white peers who care about youth RT2e_Sect06_Ch42_307-328.indd 317 RT2e_Sect06_Ch42_307-328.indd 318

SECTION 6. WORKING WITH ADOLESCENTS WHO HAVE ENDURED TRAUMA AND MARGINALIZATION 318 qualifications,frauds. have andsothey apersistent,fear ofbeingexposedas internalized often doubting theiraccomplishments, thantheirtalentor rather theirsuccessestoluck aswell asattributing affect youth who, despitetheirsuccesses, holdanimpostersyndrome—a ofbehaviorpeople pattern more effectively, have more self-control,calmer. andbe Thenarrative of low expectation continues to would to and thatthey bebetteroffifthey would justlearn relate topeoplebetter, manage themselves size, teacherqualifications, ofinstructional resources. andtheavailability of color for successbyof colorfor acknowledginginequalitiesinsociety. this chapter, we explore andhow theprocess socialization parentsprepare ofracial andpolitical can youth words,In other youth if perceive anunfairsystem asfair, to seethemselves left in are astheproblem.Later they perceive thatthey othershold ofthem. tofitthestereotypes ways andact deviant outinincreasingly types asfair.justified andbelieved When unfairsystems,youth defend negative stereo- tendtointernalize they identities, behind” come belong they tounderstandthat to groups “left previously by they the system andsystems. to examineabstractsocialstructures ability Asyouth theirracial-ethnic concurrently develop seventh, andeighthgrades. This makessense, astheir ongoing cognitive development provides youth the regulation behavioral classroom andamuch behavior moreincreaseacross indeviant significant sixth, variables. However, youth asfairhad strongerinself-esteem and whojustifiedthesystem declines accurate:to bepartially Insixthgrade, wasfairprotective study thatthesystem all for believing would berelated beliefs topoorerjustifying developmental outcomes, researchers their predictions found behavior, behaviorregulation, classroom andperceived discrimination. system- Predicting thatearly influences theirdevelopment, districts. segregated schools, suburban citiesandfundedwell below incentral thoseinneighboring most located andunequal. separate continued tobesubstantially Two-thirds attend studentsstill andLatinx ofblack 347US483(1954), Education, vs Boardof decision, studentsofcolorhave for experiences educational indevelopmental andvocational outcomes areracial disparities well-documented. DespitetheBrown courseandwithwhich thelife affects thattruly socialdeterminant relevantineducation—a especially Youth live upto—ordown to—ourexpectations ofthemandtheirexpectations ofthemselves. This is on (or Lack and the Role of Expectations Racism Thereof) Youth Development narrative,” color are a subjecttobiasedperceptions thatperpetuate ofmisbehaviorby andstories “failure educators Newer research how youth’s describes perceptions thatsurround ofthesystems themasfairornot through policy andpeacefulthrough protest.” policy white boy) (22-year-old evaluating thatis, how Isimplytake self-pitying my privilegeasareason to fightagainst racism being white. Don’t take guilt,’ thatas‘white though. Iusedto ‘feelbad’forbeingwhite, butupon makes“It privileged, mefeelextremely aboutbeingpersecuted asInever by someonefor worry have to actively fightagainst.” white girl) (22-year-old cultures. Ifeelthatwas preconceived raised withcertain notionsandengrained thatI stereotypes makes“It mechallengemyself to bemore openmindedandexposemyself to otherethnicitiesand be obliviousasawhite person.” white girl) (16-year-old privilege. makes It memore aware ofthesystematic oppression anddailyprejudices to whichImay makes“It mereevaluate myself andmy preconceptions ofotherraces, aswell asacknowledgemy transgender boy) makes“It memore aware ofmy privilegeandhow [I]can useitto helpothers.” white (16-year-old white boy) little, melikelyvery affects due “It to my insulationasamemberofthemajority.” (17-year-old consider whatit’s like forpeopleofotherraces/ethnicities.” white young (20-year-old woman) “I thinkitmakes meaware color ofwhatmy skin doesanddoesn’t afford me.It alsomakes me 33 Significant differences class haveschools beendemonstratedbetween onmeasures these of Significant 35 one suggesting theseyouth more needsocial-emotionalskills learning thanotherchildren 37,38 specifically theimpact on self-esteem, specifically behavior, internalizing deviant 34 Intheseschools, youth of 36 4/17/20 11:28 AM Chapter 42. The Traumatic Impact of Racism and Discrimination on Young People and How to Talk About It 319 4/17/20 11:28 AM

It shapes 39

To help youth who have been been who have youth help To 34 A conceptualization of racial socialization distin- messages 40 : 39 Partnering With Parents and Other and Caregivers Parents With Partnering Integrating Trauma-Sensitive Care, Health Equity, Health Equity, Care, Trauma-Sensitive Integrating Development Youth and Positive In conceptual and empirical work, researchers have focused primarily have in play researchers that parents the role on and empiricalIn conceptual work, With this differentiation, researchers acknowledge that parents varyacknowledge that parents researchers in what they choose to teach their With this differentiation, We must work hard hard work must We outcomes? influence positively influences and adverse these do weHow counteract „„ „„ Messages intended to prepare children and youth to adapt to and operate within to adapt and youth children for intended to prepare bias. Messages Preparation youth for experi- They prepare and discrimination. including to prejudice exposure a racialized world, strategies discriminationences of racial for provide and coping. Egalitarianism. diversity emphasizing and interracial equality. Messages of mistrust.Promotion about the potential for Messages discrimination and to be wary of interracial distinct These are for bias in that they preparation include about from no messages interactions. coping strategies. Cultural ethnic pride socialization. about cultural and transmit knowledge that promote Messages history and heritage. ● ● ● ● the meaning children and youth ascribe to their group membership, their expectations about experiences their expectations membership, ascribe to their group and youth the meaning children of the history knowledge their with being a group and values associated members, as group they have may beliefs and their others view about how and treat and pride, belonging their sense of group member, Racial-ethnic socialization is a strategy in a society and youth children for raising healthy various groups. of color oftenin which being a person connotations. has negative socialization. racial-ethnic their children’s youth. Political Political critical add political must thinking around socialization we with all youth. racialized succeed, used in our society forces and privilege to create are power of how awareness socialization creates about implicit need to open conversations We while leaving others behind. groups for some advantages the systembiases in education and how really is not the meritocracy it claims youth to be and provide the system at all work while we with the hope and skills educational to navigate their environments, must We Our influence the life trajectories expectations youth. of equitylevelto assure in outcomes. trust in their and strengths, build their confidence youth, of our hold the highest of expectations This and affirm their up to the fullness potential. of their live rights to abilities and inner strengths, is not only true but true of racially with marginalized youth of all youth diverse and intersecting social identities. - and disadvan discrimination, differences, Some teach group parents about race and ethnicity. children others emphasize the value of diversity and egalitarian and traditions; culture, others teach history, tage; ● ● ● ● Racial-ethnic socialization is the process by which society transmits messages to children, youth, and their youth, which societyby Racial-ethnic socialization to children, transmits is the process messages families about the significance of their and ethnicityrace and associated values and norms. Trauma-sensitive care, health equity, and positive youth development share core values and principles values core that share development youth and positive health equity, care, Trauma-sensitive practices and interventions they inform promising that can Together, and complementary. interrelated are are fundamentally They byracism. youth affected guide us in effectively to supportingresponding and and autonomy, voice, elevate safe and fostering emphasize spaces youth creating trust; based; strength the importanceThey stress and foster a participatorychoice; the solutions. own in which youth culture of viewing trauma from a historical in seeking approaches and the need for intergenerational perspective forsolutions healing. at the individual level to promote a growth mind-set. This mind-set helps children and youth to learn youth to learn and mind-set helps This children mind-set. a growth levelat the individual to promote is particuThis - individual resilience. and to create part mistakes as to accept of learning, to learn, how larly critical of poverty in the context insecurity; and economic mind-set can a growth transcend help and possibility. ability, in hope, and is anchored conditions prevailing guishes 4 general categories of messages RT2e_Sect06_Ch42_307-328.indd 319 RT2e_Sect06_Ch42_307-328.indd 320

SECTION 6. WORKING WITH ADOLESCENTS WHO HAVE ENDURED TRAUMA AND MARGINALIZATION 320 information, go toChapter29, Unconscious Biases. Examining Our point. ahelpfulstarting privilege theRelatedResources section See intheonline version. Andmore for conversations withyouth. Manycoupledwith peoplefindimplicitbiastraining reflection on power and need togo through aprocess of self-reflection before are they prepared tomostproductively holdthese work andgive hopeareal dimension. However, inourfirstparagraph, aswe describe sometimes people needallies.they And are allies powerful, extremely role should asthey modelhow anequitablesociety intheirown lives.experts Young know peopleneedwhothey have had ashared and experience background, respectful aslong young asengaged stancethatrecognizes in withadeeply people asthe have ourown setoflived experiences. These conversationscan andshouldbehad by any person, ofany socialidentities, holdmarginalized ourselves have navigatedourindividualdevelopment processes, and andmaintainappropriate boundaries,we guard againstimposingourworldview ifwe might especially able adjustment, higherself-esteem, including toyouthconsistently outcomes. beenassociatedwithmore hasconsistently favor- socialization Cultural messages youth. for messagesandpreparation related biasrelate pride for tocultural most Socialization while maintaining a keen focus onwhile maintainingakeenfocus strengths, coping, and resilience. influencesandinstead inanopen-endedwayences anddetrimental explore with theseconstructs youth intersecting identities. We theseconversations foster can withyouth and explore withyouth andcelebrate theirracial-ethnicand tohave theseconversations adults. opportunities athome orwithothercaring interact withhave varying itsimportance,allows ustoraise modelconversations, andpromote reflection. The care youth forand we reach youth. teensmay notseetherelevanceoftalkingwithusaboutracism. Some Doingso, however, development. conversations thesecrucial Itisvitalthatwe tothemany bring different spaces inwhich we topromote positive self-concepts, strategy ofanoverall racism aspart adaptive coping, andpositive ment processes andlived experiences, toassesscoping, to address promising andtointegrate interventions racial-ethnicinfluence oftheirgroupdevelop- membershipandothersocialidentities on theiridentity rolesIn thevarious we eachplay inthelives ofyouth, create we can spaces toexplore withyouth the passive recipients messages. ofsuch Instead, initiateandselectthemessages internalize. they perspectives; othersdosome still combination ofthese. orall Importantly, children andyouth are not behavioral problems,behavioral mining messages, andto remain resilient imposedby intheface ofbarriers society. dimensions ofpower andauthority,analyze ofunder- resist againsttheinternalization toeffectively children consciousness equiptheir thatenablesthem toidentifyandThey and youth withthecritical marked enoughinasociety by inequity.caution their but isnotalways promoteyouth thatsuch effort totheireffort. aslinkedonly tosucceed isportrayed theability inwhich meritocracy Parents valueand intentional inthiseffort, recognizing thattheir youth constantly receive messages ofacolor-blind ofoppressive tosuccessbecause translate socialforces. thatthisdoesnotnecessarily nize Parents are promoting aspectofourwork thedevelopment ofpositive self-concepts withyouth. isanimportant toexpeditetheimplementation ofcopingresponses. serve andcan discrimination Assessingand toconsider possibleapproaches provide to messages youthsocialization can withtheopportunity othergroups. some toameliorate ofthepainostracism from racial serve Specific and belonging can thantheirindividualcharacteristics. rather discrimination Asenseofethniccommunityconnection self-esteem ordistress are whenthey exposedtonegative thatmay events beafunction ofracial-ethnic and thosedirected atthemasamemberoftheirgroup. from to injuries can protectThis targeted youth may helptargeted youthracial-ethnic identity distinguishbetween actions directed atthemasindividuals racial asaprotective themostpowerful aspectof socialization offer heritage factor. A well-developed eling, messages, andenvironmentspromote racial-ethnicpride aboutone’s learning thatemphasize „„ A growing numberofstudieshave examinedtheconsequences ofparents’ racial-ethnic socialization As we engage youth assumptions intheseconversations, ofnegative experi- from we shouldrefrain In addition, and whileparentsresponsibility, ofpersonal stress effort theimportance they recog- Opening the Dialogue theDialogue Opening With Youth: Breaking theIce 45 and fewer depressive andfewer symptoms. 42,43 higheracademicengagement andperformance, 46,47 Strategies that provide youth of color with mod thatprovide youth ofcolorwith Strategies 48 It is also critically important that important Itisalsocritically 41 44 fewer - 4/17/20 11:28 AM Chapter 42. The Traumatic Impact of Racism and Discrimination on Young People and How to Talk About It 321 4/17/20 11:28 AM 50 eaning M 48 heir T It is also essential that as caring adults, we not only screen for negative influences for not only negative we screen as caring It is also essential that adults, 49 dentities and and dentities I What are some of the experiences you have had related to being who you are? being who you to had related have you some of the experiences What are vocationally, levels—culturally, at so many you are out who figure when you the years These are been ever you Have of these areas? in any trouble had any you Have religiously. sexually, politically, these issues? against around discriminated are? being who you identity? your You to had related have you some of the experiences What are they been handled? have How school? How? up in your show ever and racism race Do to issues related they have How peers or adults? How? with your interactions issues in your ever and racism Are race been handled? How diverse or segregated do you think the students are at your school? How diverse is your social is your diverse school? How at your think the students are do you or segregated diverse How race? talk about Dogroup? ever teachers …I am always eager to learn more about young people. How they define who they are…racially, they define who they are…racially, How people. about young learn more eager to …I am always being who as their experiences What them, as well their identities mean to spiritually…. sexually, me about yourself…. Tell they are…. to consider the identities that you about received have some of the messages you are …What you? define received? have with the messages you in comparison view yourself do you …How things about being [identity]? some of the positive consider do you …What about being [identity]? negative consider you anything …Is there view sometimes that youth appreciate to come I have families, immigrant with youth …Working you? How is it for do. family members other or than their parents differently and define themselves racial-ethnic identityDoes tension? with yours? that create family’s your balance do you …How What community? the most about your appreciate to you want parents think your do you …What the most? appreciate do you Broader questions, such as “How do you think the color of a person’s skin influences how the person the person skin influences how think the color of a person’s “How do you such as questions, Broader familiar to teens can also serve social media that are issues on events and trending Current as starting Another strategy to open conversations about race before going into exploring youth’s self-identification is strategy into exploringAnother going youth’s about race before to open conversations xploring xploring Exploring Experiences of Discrimination and Bias (Particularly When Youth Youth When and Bias (Particularly of Discrimination Experiences Exploring the Conversation) the Issue to Bring Do Not E which identity their individual influence from come development a wide variety of backgrounds, Youth youth, to know to get desire begin with a genuine must We and perspectives. experiences, lived processes, important It is at a time. youth one especially as it pertains experiences, lived their identities and to to describe of their identity them and their salient to dimensions allowing youth that are to begin by associated meanings. sees and experiences the world?” can also help us understand youth’s views race in general and their on can help us understand youth’s also sees and experiences the world?” membership in particular. racial-ethnic group and reactions. values, perspectives, identities, youth’s that explore points for conversations to start conversations with less direct questions, such as questions, with less direct to start conversations of social forces on youth’s self-concept but recognize resilience in which self-concepts are positively intact. positively intact. are in which self-concepts but recognize resilience self-concept youth’s on of social forces see themselves world. this complex in Begin with exploring youth how RT2e_Sect06_Ch42_307-328.indd 321 RT2e_Sect06_Ch42_307-328.indd 322

SECTION 6. WORKING WITH ADOLESCENTS WHO HAVE ENDURED TRAUMA AND MARGINALIZATION 322 evidence-informed strategies include different areas. include strategies evidence-informed ters withyouth andadapt according totheircognitive, emotional, anddevelopmental characteristics. These on how we respond toyouth ofracism. experiences inencoun- They representcan apply that strategies we ● ● with persistentorrecurringexposure. may ofcopingstrategies beneededateachpoint. Avariety in anticipation ofpotentialexposure, atthetimeofexposure, exposure, following andwhendealing ofcopingatdifferent youth pointsintime: torecognize types may needtousedifferentIt isimportant How Do Youth Cope With Racism? S P Validation (eg, Recent practicerecommendations, literature, thecounselingpsychology from especially ● ● ● ● ● ● ● ● ● effective strategies, to adjust their responses depending on factorseffectiveness thatmightinfluencethe of range ofcopingresponses ofsituations themtorespond withappropriateand topermit types todifferent Consequently, one ofthemostpressing facing challenges youth abroad ofcoloristheneedtodevelop ● ● ● ● ● ● ● ● ● ● ● tra sychoeducation (eg, powerful protective senseofbelonging andconnectedness. This istheplace totalkabouthow common group tocommunities identity canprovide a ofcolor Allow themtonamethesituation don’t (helpthemdefineissuesifthey know thenames). Validate andemotional theirfeelings responses experiences. tosuch andagency Advocacy examinationandpower ofprivilege andofracial attitudes Critical messages) and minimalizingself-blame(eg,Externalizing ofnegative race-based minimizinginternalization experiences) (eg, positiveDeveloping identity associatedwithmultiracial strengths exploring andopportunities community andallies.) responsive (Encouragethedevelopment ofandconnection toethnic socialsupport Culturally identities) marginalized cally consciousness (eg, andcritical Self-awareness understandingtheintersection ofraceandotherhistori- Psychoeducation (eg, responsive copingstrategies) teachingculturally Validation (eg, andvalidatingracismexperiences) normalizing „„ Responding to Youth Experiences ofRacism tegies) What isyourWhat earliestexperience dealingwithrace orracism? culture withyour friends? you feelthatotherpeopleknow andunderstandyourDo race you orculture? talkaboutrace Do or strengths thatcome from your culture. no lessdespite thisexperience. Thisisthemomentto reaffirm who you are and to recall allthe up by puttingothersaround themdown. matters mostisthatyou What are undiminishedand from that pain,to build strengths from pain,to grow from themselves pain.Sometimes, peoplelift It’s Racism hurts. hurts. Sexism hurts. real.Discrimination Butwe have ways to shieldourselves abit alone experience it. I appreciate you sharinghow thatfeltforyou. Ifinditdifficult to hurts. evenhearaboutit,let It how theyfeel aboutthis];itisreal. Hey, [or bothersorconcerns] Iknow thatithurts you here [reflect how theyhave shared with you N ormalizing and Validating T eaching Cultur 51 ally R esponsiv R acism E xperienc e Coping e Coping 51 provide guidance es) 52

4/17/20 11:28 AM Chapter 42. The Traumatic Impact of Racism and Discrimination on Young People and How to Talk About It 323 4/17/20 11:28 AM

tities) den I nderstanding the U ginalized ginalized ar M orically ist H ther The perception that one’s coping capacityadequate to not is one’s that perception The 53 O ace and ace ies on video ies on R lustration of the encounter lustration napchat story that illustrates what happened mics or storyboards that tell the story forming portions of their story through spoken word, song, or performance art song, forming portions of their story word, spoken through lustrating the story their thoughts and feelings selfies that convey with 5 or more How have you dealt with these experiences? you have How respond? you did others around How respond? did you How deal with these do you How happening or watching? this was think and feel while did you How and feelings? thoughts the experience? learn from What did you on you? have What experience impact did your how? and if so, way in some change you Did the encounter you affect sometimes It how can people. young of getting to a way have such as yours Experiences this people also have But young others. to relate you how even think and feel, you how see yourself, doing? If are say you you would well how All in all, and overcome. ability stay above to remarkable what letter with the negativity, dealing are you well for how grade letter a yourself give to were you strategies any Are there have? to want you would What grade letter yourself? give you would grade get there? think may help you can that you or ways the negativity? and stay above experiences deal with your What has helped you ɢ ɢ ɢ ɢ ɢ ɢ While the psychological research literature provides a variety of categories of coping responses, While a variety provides literature the psychological of categories research of coping responses, ɢ co Creating ɢ Il ɢ a S Creating ɢ Per such occur and and how may for where examples of certain youth encounters using concrete Prepare youth to identify This allows of such the context encounters. they depending on how can best respond coping responses the appropriate and deploy recognize reactions, their emotional what is happening, I “Ah, of internalizeinstead the harm from that comes example, race-based maltreatment—for a negative of accepting instead was talking about [stereotyping]!” if this is what my dad wonder actions. of their as an accurate reflection comment Encourage them to use narrative as a healing mechanism: telling one’s story can be incredibly empow- telling one’s as a healing mechanism: them to use narrative Encourage various can encourage teens to explore means for self-expression, We ering and healing for youth. including ɢ the stor Recording ɢ an il Creating tersection of elf-awareness and Critical Consciousness (eg, (eg, and Critical Consciousness elf-awareness ● ● n ● ● S I any coping strategy, and to possibly deploy them as needed over prolonged periods of time. Youth need to need to Youth periods of time. prolonged over them as needed and to possibly deploy strategy, coping any called coping flexibility, strategy effective an appropriate and to implement flexibility, develop the cognitive of situations. the wide range in each of meet the demands increases the likelihood that race, and ethnicity-related maltreatment, will expe- be and ethnicity-related maltreatment, likelihood that race, the increases meet the demands endeavor that coping is a lifelong youth need to remind we As mentors, stressor. riencedchronic as a must strategiesThese and strategies for each need to develop self-preservation. approaches and that we energyallow us to assess our can levels certainand decide when we take on need to issues and when we conserving our energy for the next time or for our need for and improvement. self-care pass and let it go, Caring is not self- each enough for ourselves are ourselves that we compassionately while reminding Self-preservation and is a formis essential for and care of activism. resilience or defeat. indulgence coping is and assess whether their be fully what matters most is that we with youth present ultimately, and enough. effective, adaptive, RT2e_Sect06_Ch42_307-328.indd 323 RT2e_Sect06_Ch42_307-328.indd 324

SECTION 6. WORKING WITH ADOLESCENTS WHO HAVE ENDURED TRAUMA AND MARGINALIZATION 324 interdependence predicts low strategies. endorsementofindividualistic problem-solving one’s own problems. connections a anddevelop “relational self,” anindependentselfthatsolves thandevelop rather thedominant valuesdrive interdependent toseek howcultural norms collectivistic cultural describes ing howofindividualsandtheircontext. adjustment dependson thebehaviorsandcharacteristics context, values. andcultural forunderstand- framework The person-context fittheoretical model a provides toremember thatcopingisinfluenced It isimportant factors,by several characteristics, individual including of andConnection to Culturally to deconstruct internalized racism. internalized to deconstruct youth’s todevelop mindfulness isastrategy Developing toreflect feelingsandtobegin on their capacity I E inthischapter. section the Cultureearlier andIdentity See O D ● ● individual racial-ethnic identity development processes. individual racial-ethnic identity think through theirprocesses, andcreate spaces reflection safe for whiletakingintoconsideration their onefor group mightnotbeasprotective othergroups. for tend toshare unliketheindividualisticlensofmostEurocentricfamilies. agroup identity works What ourIndigenous Nations) familism]; [called their strong orientation andNative from family Americans families,togetherness concept; American families, Latinx through theirAfrican color (African through nt xternalizing and xternalizing eveloping pportunities pportunities does notbecome aburden. youth’srace andtoprovidespacedifference of asafe inwhich based on thesocialconstruct identity such. groups andhavingspaces Affinity or communities thatbelong toaffirm tothem are important assessing youth connectedness andbelonging connections andbrokering meaningful ifyouth desire with youth. space youth safe for thatthismay betheonly todoso. Recognize This aspectalsoincludes ences. Inthesemoments, we ourpresence bonds needtouseall andempathy listenandform toreally mindful intent, present whenyouth oursensestobefully andusingall talkabouttheirpainfulexperi- Fostering positive relationships withus! andconnections starts Through listening, andwith actively orateacher. another person,stress by advice askingfor orassistancefrom afriend often coping—whenanindividualusessocialconnection todealwith seekingsocialsupport event—and thestressful coping—when anindividualenacts confront acourseofbehaviorstoalterordirectly responsive positive copingstrategies, culturally Brainstorm thatis, abalancebetween problem-solving Cultural valuesalsoinfluencewhatisconsideredCultural positive coping. Research among Asian Americans It is critical thatwe how learn teens areofdiscrimination, copingwithexperiences It iscritical allowthemto ernalization of watchful oftheways you speakto yourself. ourselves down. onthe Reflect ways andbe you speak to that yourself.you stayalert It isimportant You know how we speakto ourselves. We speakto ourselves inways ourselves that lift uporput Is connecting withacommunity somethingyou would like? you develop thisconnection? How doyou fitinto this Inwhat community? ways are you connected to this Howcommunity? did with? Remember, Iamyour advocate. andencouragement. you feelthatthereturn to Do forsupport isacommunity thatyou identify group ofpeoplewhotheycan ofcommunity—a identifywith,canimportance leanon,andcan I want you to know thatyou have me. Many young peopleIcome across alsotalkaboutthe R esponsive P 56 ositive Even among third-generation AsianAmericans, astrong prevalenceof cultural A ssociat N M egativ inimizing I dentit E S thnic Community and ed ocial e W y (eg, R ith S ace- upport ( upport S M elf-blame (eg, B E ultiracial ased xploring E ncour M essages) E S xperiences) trengths and trengths and A age the M llies) inimizing inimizing D ev elopment elopment 57 Families of 54,55

4/17/20 11:28 AM Chapter 42. The Traumatic Impact of Racism and Discrimination on Young People and How to Talk About It 325 4/17/20 11:28 AM

ttitudes A This awareness 58 acial R er and of ow P rivilege and P These conversations can prepare them to understand the language and actions actions and them to understand the language can prepare These conversations gency 50 A xamination of xamination E is that you make your own truth by embracing yourself and loving the unique strengths unique strengths the and loving yourself embracing by truth own your make is that you have. that you Sometimes young people may have received negative messages or may have had negative had negative have messages or may negative received Sometimes have people may young My it as truth. you wish for and they take the outside from who they are about experiences Agency is the ability to be part of the solution, the ability to identify and pursue Agency agency. is the ability to be part of the solution, Foster It’s important to recognize and discuss that in our society, certain forces and structures around power certain power and structures around forces importantIt’s to recognize and discuss that in our society, and regardless of their race and privilege all with youth, power about conversations should have We This critical opportunities examination can provide and youth to understand racial racism for white It is important to stay alert to the messages that you say to yourself. We need to be mindful of our need to be We to yourself. It is important say alert to stay that you to the messages Just as we have prepared bystanders in cases of bullying to act and intervene, we should train and we in cases bystanders of bullying prepared have and intervene, Just as we to act and privilege can about power help them better understand the conversations of color, youth For should learn to critically you recognize RacialWhen attitudes. about a stereotype, hear or read you dvocacy and of power and privilege allows them to reflect on what they see in their families and communities and on what they see in their families and communities and privilege them to reflect allows of power White receive youth and empathetic society. equitable, a just, toward their commitments strengthen about meaningful to have conversations eager are white youth Many socializationlimited racial messages. “white with of them as some wrestle even theyrace and recognize differ how generations, previous from “white shame.” or guilt” A should be youth with working Adults Advocacy strategy is a powerful for dealing with racism. Advocacy. to support to build their capacity youth prepared for self-advocacy. youth we assist In trauma-sensitive care, of change. agents creating outlets for effectingchange, positive recognize to help youth it is our role do so, As we experiences. of their lived their narratives in creating and inequality served have to mold adversity, of trauma, their experiences in the face how and resilience can coach them how We for change. their idealism and desire build on must We them. and strengthen Critical Paired is socialization. of examining privilegecalled and power political The process and power. Privilege Our task is to use understandable language equitable society. it can to a more lead with critical thinking, awareness. of all and designed to create that is appreciative a critical need to have and to think about those forces way We and authority of fairness. in the way get we goal is to see them so that can celebrate The and take full credit to start us. seeing these issues around can we how on work achieve something—to can’t blame ourselves when we fordon’t our successes and foradvocate ourselves using our creativity and respect. them for critical action. and collective to best prepare social examination ethnicity, They meant can examine what and privilegefor have race reactions. their emotional privilege and process to think about it previouslythem and begin to recognize that not having had is itself a sign of privilege. them to better understand the obstacles of color routinely navigate and establish It can youth prepare to examine and counter the individualistic them a space It gives divides. racial-ethnic alliances across recognizing inequities in structures and effortby and one’s that allnarrative around success revolves White see racially youth motivated discrimination them. bias all and around systems. own self-talk and realize when we might be repeating negative messages that we have absorbed have from that we messages negative might be repeating self-talk and realize when we own by And with ourselves. and present in the situation present present, being can by do that We the outside! “Where from?” is this thought [or feeling] coming continually asking ourselves, allies social change. can take to create witnesses to racially as alliesempower for individuals. targeted motivated discrimination and bias to react dynamics in our society. about power conversations should introduce we that, But before the internalization of It can that promote counter the forces to navigate. dynamics had they have may support affirmations and It can positive provide of the criticaldevelopment conscious- messages. negative ness and agency liberating truth through telling. culture! most about your love to focus the things that you on to yourself this and then use this as reminder RT2e_Sect06_Ch42_307-328.indd 325 RT2e_Sect06_Ch42_307-328.indd 326

SECTION 6. WORKING WITH ADOLESCENTS WHO HAVE ENDURED TRAUMA AND MARGINALIZATION 326 and as we contribute to the modification of socially toxic environments, ofsocially and aswe tothemodification contribute of theyouth we serve. resilience. Hopefosters work we engage andadvocacy insystem-level When negative effects ontothelives pervasive andexert forces toinequitiesanddisparities thatcontribute housing, policing, andotherdeterminants. We must modifythe get involved thateffectively inways the affect care youth for: we thatespecially changes that influence thehealthdeterminants education, act on our world in ways that contribute to our collective well-being and for thecommon toourcollective well-being andfor thatcontribute good. inways act on ourworld Young peoplemay intheirway. dream seehurdles lesswhenthey this solidarity that we find opportunity for Healing,” “Radical thatwe findopportunity this solidarity has decentered, share theburdens have they carried, and treat theirpainasourpain. itisin Because withyouth,stand insolidarity families, andcommunities andthatoursociety whoare marginalized passes “Audacious Hope,” withthosewhohave suffered. ahopethatstandsinsolidarity We must channel theirpainintopower.channel This responsivereflects how diverse positive culturally parents emotions, we shouldtapintoyouth’s idealismandpassionaction for through future goal setting. This will abetterof system istheultimate mechanism healing. for to become involved andhow toact. Helping seethemselves youth they gain ascocreators where ownership into others Hope.” “Critical ● ● deadly tidesofwealth inequality,deadly group xenophobia, andpersonal despair.” reclaiming their dreams needs to be paired with strategies that foster critical thinking. theirdreamsreclaiming needstobepaired critical thatfoster withstrategies Askteens, beenlimitedby thenegativehave messageshave often thatthey encountered insociety. This process of just, equitable, fair, society. andcaring acts ofcourage. thesegreatest Because individualacts ofcourage, collectively, toa are whatmove uscloser their pride,encourage themtoreclaim todream, theirright toreclaim andtodream bigastheirgreatest ofachieving. capable are truly Aswe work racism, withyouth indismantlingtheirinternalized we their hopesanddreams, show theircommunities can they whatthey, asindividualsandgroup members, engage inthecreation themasactive participants ofafairer society. Aswe encourageyouth on tofocus youth by exampleandguidethemon howtheiranger tobestchannel andpainintoprosocial that ways Getthepress inv ɢ Engage incomm ɢ Write alettertoco ɢ mone Raise ɢ Doasurve ɢ Demonstrate ɢ office for Run ɢ Advoc ɢ others. Educate ɢ own life. alistofoutletshow Offer tocreatechange. League proposes The Anti-Defamation advocate inaway thatislarger needtoknowcan thanjustexaminingtheir they they Sometimes doyou“How changethesethings?” thinkwe can them. how you support See can control toachieve over theircircumstances, opportunity Give youth every decisions, andfuture. Ask, Most important, adults andaboutyouth whocare for must system-level toadvocate for learn Once you know seeasstandingintheirway, whatthey explore couldbelessened. how thosebarriers Then, ask, After validating youth’sAfter andexperiences, feelings assessingcoping, andhelpingthemnamedifficult Most of us find ourselves coachingourteensto Most ofusfindourselves reenvision theirboldest, greatest dreams, astheirdreams ɢ ɢ ɢ ɢ ɢ ɢ ɢ ɢ ɢ What isstandinginyourWhat way? IwasIf godmotherandgranted your fairy you 3wishestoday, whatyou would wishfor? How can we changethat? anything andnotfail, whatwould you like to achieve? madeyou aboutthat? What stop thinking to yourself thatyour you dream mightbeunattainable?Why? If were told thatyou could achieve isyourWhat greatest, you boldestdream? have not,how Do one?If come? Have you ever thought ate for legislation.ate for y abouttheissueinyour andshare own theresults. world y. . . olved. unity service.unity mpany. 63 Critical hopedemands Critical “a committed tochangethe andactive struggle 65 the process that builds our capacity to theprocess thatbuildsourcapacity 62 weand infuse intoourselves 64 Critical hopeencom- Critical 59,60 teach 65 61 : 4/17/20 11:28 AM Chapter 42. The Traumatic Impact of Racism and Discrimination on Young People and How to Talk About It 327 4/17/20 11:28 AM 69 The paper was 68 The acronym, in and of itself, in and of itself, acronym, The 67 Treatment models and interventions of the intersection that reflect Treatment 66 A Summative Call to Action to Call A Summative The Pervasive Ways That Racism Is Structural That Ways Pervasive The Bringing the Ecological Lens to the Community the to Lens the Ecological Bringing The entire paper can be downloaded for readers to applyreaders paper to their organizationsfor (www.jahonline.org/ downloaded can be The entire on own policy of Pediatricsreleased its on the impact racism statement AmericanThe Academy of We belong to each other. Together, regardless of race and beyond race, we must want what is right must we race, and beyond of race regardless Together, other. to each belong We „„ „„ „„ borne out of the need to create action at the system level action to shield our teens fromborne to create out of the need the new of hate wave crimes the globe. around article/S1054-139X(18)30239-8/fulltext). child health (https://pediatrics.aappublications.org/content/144/2/e20191765). and adolescent anchors the model to Indigenous Aztec Latinxanchors the model to Indigenous and African beliefs in which the heart symbolizes the is the source rather than the brain, The heart, the spiritcenter of life and seed of humanity where reside. anchors healing The approach trauma cultivating and in from and emotions. memory, of human wisdom, in the is also grounded approach The which fosters hope and resistance. self-determination, promoting or staying to their connected strengthening, from comes that healing premise individuals reconnecting, ethno-racial roots. Racism exacts a heavy toll on the physical, emotional, and social health and well-being of youth, families, families, of youth, and well-being and social health emotional, the physical, a heavy tollRacism on exacts It is a formidable social determinant underlying inequities that disproportionately and communities. and it undermines and demeans all of society. is corrosive, Racism affect racialized in our society. groups to hurt continue we each other and ourselves? Need that will of youth the generations to leave are if we for greater and work for better, aspire for each other, of us can do it alone, None aftercome us a just and equitable society—all caring while for each other. canbut we do our part each critical each have - and we and complementary work youth to play—as roles we each ways that the many Through peers. and parents, researchers, educators, clinicians, advocates, ers, fully that they are ensure equipped with the tools to be critically must we conscious, lives, touch youth’s and fully our society despite where has engaged institutionally courageous, interpersonally generous, resist against undermining That they multiple identities, can effectively their negotiate them. positioned and interpersonal, internal, many of adversity society’s caused in the face by resilient and stay messages, caring, fair, honest, waysare authentic, in that differences That theyacross can connect isms. institutional That they can That they harmoniouslycan live society. in our increasingly diverse and compassionate. Youth need world. a better creating effectively together toward build alliances with their peers and work with them, work must and we inherited, they have the racial and social divisions down the tools to break It is also critically and systems important that just as forms consider of oppression that we as equals. vertical of approaches Rather than single axes, forms so are of justice. interrelated, are of subordination multidimensional are that we should consider we Matter, Lives Trans or Matter, Black Lives #MeToo, multiple systems by affected are we learn how beings who hold within ourselves intersecting identities, Horizontal and develop horizontal that strive for justice. intersectional approaches of oppression, each hold which identities we the many valued and through which are all lives through approaches celebrated. define us and are To emphasize the negative and pervasive impact of racism on youth health and well-being, the Society emphasize and pervasive the negative health and well-being, youth of racism on impact To paper. a position Health and Medicine Diversity released for Committee Adolescent Healing from racial-ethnic trauma directed at racial-ethnic groups requires that individuals, families, families, Healing from that individuals, requires racial-ethnic groups at trauma racial-ethnic directed the ways over in whichthey and power are level of control some and hold create and communities internallyand externally oppressed. trauma-sensitive care and liberation psychology, such as the HEART (Healing Ethno-Racial Trauma) Trauma) Ethno-Racial (Healing suchthe HEART as liberation psychology, care and trauma-sensitive framework a viable integrative model provide healing. to promote RT2e_Sect06_Ch42_307-328.indd 327 RT2e_Sect06_Ch42_307-328.indd 328

SECTION 6. WORKING WITH ADOLESCENTS WHO HAVE ENDURED TRAUMA AND MARGINALIZATION 328 Related VideoContent father he istoday. thisway, In love opensthedoortoward hope, andhopeleadsto change. curious abouthow hemanagedto findhis way back to her, how he overcame and grew into the mourns that he missedmostofJessica’s love childhooddueto hispastdrugaddiction, is and wonders abouthercompetence andcourage to askfor helpandsupport. When Dad anger andshamethat shedoesn’t have what ittakes to helpherautisticson,love celebrates love seeksto understandwhat gave himthestrength to goat all. When asinglemomexpresses produces change. strength, gifting, growth, competence, andcourage. Love isthepathway to hope, andhope fights throughto seeevidence thedarkness oflight and grace intheirlives, theproof of to empathize withothersintheirbrokenness. Love carefully listens withoutjudgment. Love to muster upemotionsyoushoulder? Isittrying don’t possess?No. Love iswhenyou choose whotheycan’tex-partner stand. Maybe, justmaybe. Butitallbegins withlove. courage to setboundarieswithanaggressive teenager. Maybe theycancollaborate withthat something new. Maybe theycanrespond to littleJohnny differently.Maybe theycanhave the strength, conviction, andasubtlepersuasionthat thingscanbedifferent. Maybe theycantry produces withhopecomes change. faith,andfaithproduces Hopeincreases hope—and problem-saturated background, theyallfindtheirhealinginone word: love. love Because progress withafamily?” What I’ve found, that irrespective oftheculture, gender, religion, or you combat years and, insomecases, centuries oftrauma andshameto forge any meaningful painful biasesthat Igreet whenIshake my firsthandduringtheintake session. white peopleoverseeing thesystem have concluded you are unfit. These are someofthe of theirpastchoices. For disenfranchised familiesofcolor, thismessageisaconsistent theme— thenegativeresurfaces self-concept that theyare than”“less andwillforever live intheshadow the negative voices telling hershefailed. For familiesovercoming thismessage addiction, the singlemom,thismessageofincompetence shakes deepinsecuritiesandreinforces all in my inbox, isembeddedintheshamefamiliesexperience For whenIopenupservices. community told themtheyare unableto overcome theirtrialwithout “professional help.” with various presenting problems. Whatever may theiraffliction be, someoneintheir system/ to receive familytherapeutic services. These familiesare from abroad range ofdemographics in severe for crisis, them hasdeemeditmedicallynecessary somuchthat amedicaldoctor asafamily-based therapistI serve for bothchildren andtheirfamilies. are The familiesIsupport FamiliesSupporting as They NavigateBiasedSystem anOtherwise Children’s Hospital of Philadelphia Philadelphia of Hospital Children’s Challenging Stereotypes. Stereotypes. Challenging When parents are grilling young Rashawn abouthow hemissedschoolmostofthemonth, What doImeanby love? Isitjustwarm affections, sweet words, andagentle rubonthe One may ask, “How doesatherapist overcome theseobstaclesinyour situation? How do And thismessageofhelplessness, from thiscontext whichareferral ofinadequacy arrives Bracho-Sanchez, Center for Parent and Teen Communication, Communication, Teen and Parent for Center Bracho-Sanchez, —Michael Howard—Michael MS,LPC Ryan, 4/17/20 11:28 AM Chapter 42. the traumatiC impaCt of raCism and disCrimination on Young people and how to talk about it Int J m J . Published . to the causes of health Am J Prev Med eds. Handbook of Social Psychology. Handbook eds. cles/10.1186/s12939-017-0532-z . 2016;52:135–145 those statements in your own words: make words: own your in statements those include now, in the short term. In the long ey also have ready to do so. Has your to be uez TP. Transmitting trauma: a systematic review of time when you felt wrongly judged? Or a time you feel uncomfortable or not ready? Where are ood experiences: expanding the concept of adversity. A and Medicine position paper (see the Related om the Inside Boulder,Out. CO: Sounds True; 2018 biomedcentral.com/arti of all diverse youth’s ethnic identities? Child Abuse Negl ame that moment and move forward? . 2018;199:230–240 n bring to your space to make it more welcoming, as well as . 2016;153:27–34 g professionals should be an ally to youth who have endured who have ally to youth be an g professionals should r) to analyze whether you have in place the components that the Adverse Childhood Experiences (ACE) Study. bias. In: Fiske ST, Gilbert DT, Lindzey G, Soc Sci Med . 2019;109(suppl 1):S48–S55 https://equityhealthj. Soc Sci Med Consider writing how would you say some of some say you would how writing Consider them yours! o . 2017;16(1):43. Am J Public Health . 2015;49(3):354–361 You can use the Society for Adolescent Health Resources section in this chapte society recommends. Choose which ones you could term, what actions could you take to make your environment and organization inclusive? We believe that all youth-servin organization done the groundwork to prepare them to do so? Have you implemented implicit bias recognition and training? (See the Related Resources section.) marginalization, discrimination, and racism. But th How has power and privilege affected you? Do any pieces of these conversations above make you in your own identity exploration? Have you had implicit bias training? How could your practice setting be intentional in celebrating difference or different identities? What elements do you think you ca Can you write a paragraph about or think about a someone made you feel that you did not belong to a group? How did you feel? Were you able to move forward? What helped you refr strengths the celebrate to inviting, more        Group Learning and Discussi Learning and Group Reflection on/Personal Reflection Personal References Group Reflection Group 4. Heard-Garris NJ, Cale M, Camaj L, Hamati MC, Doming vicarious racism and child health. 10. Jones NL, Gilman SE, Cheng TL, Drury SS, CV, Hill Geronimus AT. Life course approaches disparities. 1. Blodorn A, Major B, Kaiser C. Perceived discrimination and poor health: accounting for self-blame complicates a well-established relationship. Prev Med Vol 2. 5th ed. Hoboken, NJ: John Wiley & Sons Ince; 2010:1084–1121 7. Ruteere M. Contemporary Forms of Racism, Racial Discrimination, Xenophobia and Related Intolerance. Geneva, Switzerland: United Nations; 2016. A/71/325 8. King R. Mindful of Race: Transforming Racism Fr 9. Wade R, Cronholm PF, Fein JA, et al. Household and community-level adverse childhood experiences and adult health outcomes in a diverse urban population. March 4, 2017. Accessed September 19, 2019 6. Dovidio JF, Gaertner SL. Intergroup Equity Health 2. Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the in adults: death of causes leading the 1998;14(4):245–258 3. Cronholm PF, Forke CM, Wade R, et al. Adverse childh 5. Khan M, Ilcisin M, Saxton K. Multifactorial discrimination as a fundamental cause of mental health inequities. SECTION 6. WORKING WITH ADOLESCENTS WHO HAVE ENDURED TRAUMA AND MARGINALIZATION 22. Jones CP. Levels of racism: a theo a racism: of Levels CP. Jones 22. September 19,2019 https://www.genome.gov/about-genomics/fact-sheets/Genetics-vs-Genomics website. Institute Research Genome Human National sheet. fact genomics vs. Genetics 21. 2014 University Press; Th Race: of Myth The RW. Sussman 20. Social and Diversity for Teaching eds. P, Griffin founda Conceptual P. Griffin B, Jackson R, Hardiman 19. Accessed October24,2019 website. WhatProctor D,PloughA. ArkinE,OrleansT, is BravemanP, health equity? Robert Wood Johnson Foundation 18. final-1.pdf on health care outcomes: a systematic review. review. systematic a outcomes: care health on influence its and professionals care health among bias racial/ethnic Implicit al. et KM, Lee MV, Chapman WJ, Hall 26. content/uploads/2016/11/Science-of-Equalit York New Care. Health and Education in Threat Stereotype and Anxiety, Racial Bias, Implicit Addressing Tropp LR,GoffPA,PowellJA. GodsilRD, 25. Accessed September19,2019 . https://equityhealthj.biomedcentral.com/articles/10.1186/1475-9276-11-59 identity. racial American African of reconceptualization post-millennials-on-track-to-be-most-d https://www.pewsocialtrends.org/2018/11/15/early-benchmarks-show- website. Center Research Pew yet. generation best-educated diverse, most be to track on generation “post-millennial” show benchmarks Early K. Parker R, Ry 15. SpringerNature;2019:29–54 Cham, Switzerland: [Internet] Adolescents. Diverse Ethnically and Racially Among Equity Health Promoting eds. VL, Chulani MV, Svetaz L, Barkley In: realities. current and context historical disparities: health Adolescent M. Trent CA, Robinson 14. adulthood: an integrated conceptualization. conceptualization. integrated an adulthood: Lee SM, Quintana AJ, Umaña-Taylor 13. 2001. Communication; Health for Center MA: Boston, Action. for Foundation a and Research of Synthesis A Teens: Raising AR. Simpson 12. . Accessed September 19,2019 . Accessed https://www.dismantlingracism.org/ Di al. et B, Carlson C, Brown A, Ayvazian 30. Accessed September19,2019 Assess for Center PA: Conshohocken, Building. Community and Privilege White Script: the Flipping B. Major D, Bivens S, Leiderman M, Potapchuk 29. 11. Gee GC, Hing A, Mohammed S, Tabor DC, David R. Racism and the life course: taking time seriously. seriously. time taking course: life the and Racism R. David DC, Tabor S, Mohammed A, Hing GC, Gee 11. g/wp-content/uploads/2019/04/Equity 2018. https://www.equityinthecenter.or Build WORK: to WOKE to AWAKE Center. the in Equity 17. 28. Hays PA. Addressing the complexities the Addressing PA. Hays 28. Washingt Healthcare. in Disparities Health What Treatment: Unequal Medicine. of Institute 27. health care organizations. organizations. care health he the Closing al. et ST, Wong CM, Varcoe AJ, Browne 24. 1669. https://www.thelancet.com gap in a generation: health equity through action on the social determinants of health. health. of determinants social the on action through equity health generation: a in gap CommissionS; Taylor TA, Houweling RJ, Bell S, Friel onM, Marmot Social Determinants of Health. Closing the 23. 1215. https://www.ncbi.nlm.nih.gov/pubmed/10936998 Public Health. Public 16. Sellers RM, Smith MA, Shelton JN, Rowley SAJ, Chav SAJ, Rowley JN, Shelton MA, Smith RM, Sellers 16. September 19,2019 https://www.rwjf.org/en/li . Accessed September 19,2019 September Accessed . 2019;109(suppl 1):43–47 2019;109(suppl https://www.hsph.harvard.edu/chc/raising-teens Int J Equity Health. Equity J Int . Accessed September 19,2019 September . Accessed brary/research/2017/05/what-is-health-equity-.html on, DC: National Academy Press;2002 DC:National on, retic framework and a gardener’s tale. tale. gardener’s a and framework retic ment and Policy Development; 2005. ment andPolicyDevelopment; , NY: Perception Institute; 2014.https://equity.ucla.edu/wp- Institute; NY: Perception , e Troubling Persistence of an Unscientific Idea. Cambridge, MA: Harvard MA: Cambridge, Idea. Unscientific an of Persistence Troubling e iverse-best-educated-generation-yet RM, et al. Ethnic and racial identity during adolescence and into young into and adolescence during identity racial and Ethnic al. et RM, of culture and gender in counseling. counseling. in gender and culture of Child Dev Child y-Vol.-1-Perception-Institute-2014.pdf smantling Racism Works Web Workbook website. Workbook Web Works Racism smantling 2012;11(1):59. Am J Public Health Public J Am Justice. 2nd ed. New York, NY: Routledge; 2007:35–66 Routledge; NY: York, New ed. 2nd Justice. . 2014;85(1):21–39 . Accessed September 19, 2019 . AccessedSeptember Pers Soc Psychol Rev. Psychol Soc Pers ous TM. Multidimensionalous mo tions for social justice education. In: Adams M, Bell LA, Bell M, Adams In: education. justice social for tions alth equity gap: evidence-based strategies for primary for strategies evidence-based gap: equity alth care Providers Need Providers andcare toKnow Ethnic AboutRacial ing a Race Equity Culture. Washington, DC: ProInspire; DC: Washington, Culture. Equity Race a ing . 2015;105(12):e60–e76 . Am J Public Health Public J Am https://www.capd.org/white-privilege . Published November Published . . Updated September 7, 2018. Accessed Updated September7,2018. . -in-Center-Awake 1998;2(1):18–39 J Couns Dev Couns J . Accessed September 19, 2019 September19, . Accessed Lancet. . Published May1,2017. Published . del of racialidentity: a . 1996;74(4):332–338 2008;372(9650):1661– . 2000;90(8):1212– -Woke-Work-2019- 15, 2018. Accessed 15,2018. Am J J Am . Chapter 42. the traumatiC impaCt of raCism and disCrimination on Young people and how to talk about it . Cultur Divers nn Am Acad Rev Res Educ. . 2003;2(4):307– Cultur Divers Ethnic . Accessed September Int J Intercult Relat. Self Ident . Accessed September 19,. Accessed 2019 . 2014;42(2):170–200. view of the literature. 2009;29(1):122–141 . 2006;42(5):747–770 https://momentousinstitute.org/blog/talking-to- . 2009;32(1):64–88. Couns Psychol rkel C, adolescents’ early Nair R. Mexican-origin . 2019;90(1):180–195 J Early Adolesc. Understanding the complexities of ethnic-racial of complexities the Understanding Dev Psychol 19:149–168 and perceived socioeconomic stratification: associations model of stereotype threat effects on performance. Psychol effects performance. stereotype threat of on model https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476942 son HC, Spicer P. Parents’ ethnic-racial socialization J Behav Med ss or justifying the system? ss or justifying the system? A qualitative analysis of 2014;85(1):21–39 high achieving women: dynamics and therapeutic intergroup a relations: re disparities in urban, suburban, and rural areas. A Child Dev . 2018;65(6):669–680 1997;1(4):200–214 New Mestiza. 2nd ed. Aunt Lute Books; 1999 racial identity and involvement with school. school. with involvement and identity racial Child Dev. RM, et al. Ethnic and racial identity during adolescence and into young ion, ethnic identity, and self-esteem: Web-based survey of international adult . 2006;15(3–4):153–172 l E, Baker A, Paradies Y. Paradies A, Baker E, l ed me: re-examining work with black boys through a culturally sustaining https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846409 . 2017;52(5):561–584 . 2015;21(3):391–399. 1978;15(3):241–247 Appl Dev Sci. rland: Springer Nature; 20 race. Momentous Institute website. J Couns Psychol minority and majority groups: a 30-year systematic review. and directions for future study. Urban Educ nih.gov/pubmed/24465033. Accessed September 19, 2019 nih.gov/pubmed/19127420. Accessed September 19, 2019 . 2016;22(1):93–103 rper GW, Fernandez MI; Adolescent Trials Network for HIV/AIDSethnic and IntervenSexual tions. . Published January 8, 2018. Accessed September 19, 2019 eum eum BT, Thai CJ, et al. Practice recommendations for addressing racism: a content analysis of the a . 2009;15(3):203–214. Psychotherapy (Chic). . 2017;674(1):199–216 J Ethn Cult Divers Soc Work ni VL. Intersecting identities and racial and ethnic minority in lesbian, gay, bisexual, and transgender dúa G. Borderlands/La Frontera: The hy MO, Owen MT. Cultural socialization and school readiness of African American and Latino preschoolers. identity development among gay/bisexual/questioning (GBQ) male ethnic minority adolescents. (LGBT) youth. In: Barkley L, Svetaz MV, Chulani VL, eds. Promoting Health Equity Among Racially and Ethnically Diverse Adolescents. Cham, Switze 40. Priest N, Walton J, White F, Kowa socialization processes for both 37. EB, Wolf S. Developing critical consciousne Godfrey teens-about-race counseling psychology literature. with well-being among Dominican and black American youth. 43. Rivas-Drake D, Hughes D, Way N. Public ethnic regard 44. Oyserman D. Bybee D, Terry K. Gendered Pol Soc Sci https://www.ncbi.nlm. Ethnic Minor Psychol 38. CE, E. For better or worse? System-justifying EB, Santos Burson beliefs Godfrey in sixth-grade predict trajectories of self-esteem and behavior across early adolescence. 324 45. Caug Minor Psychol 52. Brondolo E, Brady Ver Halen N, Pencille M, Beatty D, Contrada RJ. Coping with racism: a selective review of the literature and a theoretical and methodological critique. Cultur Divers Ethnic Minor Psychol 2014;43(pt B):139–155 41. Hughes D, Chen L. When and what parents tell children about race: an examination of race-related socialization among African American families. 1991;17(1):335–409 34. Logan JR, Burdick-Will J. School segregation and 31. Johns M, Forbes Schmader T, C. An integratedprocess Rev. 2008;115(2):336–356. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2570773 33. Schofield JW. Chapter 8: school desegregation and 32. Anzal 35. Johnson LP. The status that troubl pedagogical framework. framework. pedagogical 39. Hughes D, Rodriguez J, Smith EP, Johnson DJ, Steven practices: a review of research Accessed September 19, 2019 46. Umaña-Taylor AJ, Quintana SM, Lee adulthood: an integrated conceptualization. 42. Mohanty J. Family cultural socializat adoptees. 47. Umaña-Taylor AJ, O’Donnell M, Knight GP, Roosa MW, Be functioning. psychosocial and identity, ethnic socialization, ethnic https://www.ncbi.nlm. 48. Chula 49. Jamil OB, H 36. Clance PR, Imes SA. The imposter phenomenon in intervention. attributions for poverty and wealth among low-income racial/ethnic minority and immigrant women. 19, 2019 50. Rose S. Talking to teens about 51. Miller MJ, K SECTION 6. WORKING WITH ADOLESCENTS WHO HAVE ENDURED TRAUMA AND MARGINALIZATION Adolesc Adolesc communities: College Press;2010 2009;79(2) Connected. NewYork,NY:Fireside;2002 University Press;1996:85–99 2004;35(4):446–459 pee Psychology; vol1 Pediatrics Community youth-serving England: Leadbeater University Press;2018 Theoretical ModelsofHuman Adolesc Adolesc Psychol. Kirwan Institute for the Study of Race and Ethnicity National Juvenile Justice Network Justice Juvenile National Scenarios and Youth-Serving Providers: A Call to Action for Organizational Change” Organizational for Action to Call A Providers: Youth-Serving and Medicine Health Society for Adolescent National LGBT Health Education Center National LGBT Health Education more. and orientation, sexual gender, race, about biases implicit their Harvard University Project Implicit: Related Resources National Center for Youth Law 69. 68. 67. 66. 65. 64. 63. 62. 61. 60. 58. 57. 55. 54. 59. 56. 53. r Trent M,Dooley Svetaz MV, NY, Chavez-Dueñas Nelson Ginwright West Duncan-Andrade Garbarino Anti-Defamation Ward Hagerman Lam Magnusson Lerner Ward Ma g C. Cheng victimization TL, 2003;84(2):425–438 Health Dev AG, Palgrave C.

JV. JV. Raisingresisters: . 2019;144(2):e20191765 RM. G, BJR, Chow Hope

Pediatrics, . 2003;2003(101):3–23 Zane Cognitive The cultivating Prilleltensky providers: SA. J. MA.

2018;63(2):257–261 . i V, Chulani Theories of Theories D. Theperson Way N, Way Raising CM, Skin on Macmillan; 2010 Macmillan; and Black NWS. White DG, DougéJ;American a League JMR. psychologic Chen Tightrope: We’re and and children eds. Urban eds. Adames Youth a hope, Ethnic

call Kids: t KJ, Westtt I, human Note to Committee motivational processesunderlyingcoping WT. website. eds. In: to De approach: concepts, the roleoftruthtellingin resistance, Rising: Growing differences Teaching action HY, Implicit Bias and Juvenile Just Juvenile and Bias Implicit in velopment. Community The Words al development:

educators: Girls: a Implicit Bias: Why It Matters for Youth Justice Youth for Matters It Why Bias: Implicit e distress.

socially https://www.adl.org. AccessedSeptember19,2019 Pere This center offers online experiences that allow individuals to gain insight into into insight gain to individuals allow that experiences online offers center This moderation al. Activism and

on for Racism and and “Racism and ItsHarmfulEffectson “Racism Resisting Stere Resisting Up and z-Chavez JG, Our Adolescence.

organizational Learning to Address Implicit Bias Towards LGBTQ Patients: Case Case Patients: LGBTQ Towards Bias Implicit Address to Learning in J Hoboke Academy toxic With om. New Wisdom. : In Psychology: Sch Sch action. coping hope Children contemporary perspe Psychol. of environment. measurement Privilege required Radical n, NJ: n, culturally Am its with

Understanding Implicit Bias Implicit Understanding of Pediatrics Salas The otypes, the psychologicaldevelopmentofAfrican American l effects harmful to Psychol change: 2018;70:89–104 interpersonal John Be Healing in York, impact SP. when Pursuit Emotionally ice: A Review of the Literature the of Review A ice: a normative Creating Child Wiley Healing Racially models,

. 2019;74(1):49–62 the NY: SmileyBooks;2008 growing Section of in

of flexibility: Society ctives. Care racism & Sons Inc Sons & Urban Libe on stressors. Identities. ethno-racial Divided and coping

nondominant rong, Socially Strong,

escent Health, Council on Council Health, on Adolescent roses ration f f In In: Damon NondominantRacial–Ethnic Youth research for on child America. Exch. a dual-process Adolescent es on strategies in America. ; J Cross Cult Psychol Cult Cross J

and 1998:1–24.

New concrete. 1998;(122):8–10 trauma strategy. and Well-being. w York, New York, W, racial–ethnic adolescent Smart, New Lerner RM,e Health

in Harv Harv Handbook Taiwanese NY: New New model. Latinx York, Spiritually Basingstoke, Educ Educ NY: New r r Di and health.

. J Pers J NY: youth immigrant Teachers Child Child York Medicine. Rev ds. adolesce of New Child

Soc Soc girls. In: . and

York

nt J J