Stress, Coping, and Depression Among Black Urban Adolescents

Stress, Coping, and Depression Among Black Urban Adolescents:

Implications for School Counseling

Latoya C. Conner

Stanford University

Christine J. Yeh

University of San Francisco

Abstract

This research explored the interrelationship between stress, cultural coping, and

depression among 208 Black-identified high school students at an urban high school.

We hypothesized a statistically significant relationship between African-centered

worldview, spirituality, collective self-esteem, and creative coping. These variables were

also hypothesized to be predictive of symptoms of depression. Simultaneous regression

analyses revealed that African-centered worldview, collective self-esteem and

spirituality were predictive of cultural coping practices. Adolescents coped with

depression in spiritual and creative ways, and those with family and peer support

reported fewer symptoms of depression. Implications for school counseling are

discussed.

Keywords: stress, cultural coping, depression, African American adolescents,

spirituality, school counseling

Stress, Coping, and Depression Among Black Urban Adolescents:

Implications for School Counseling

With media attention focused on school shootings, the public debate on

accessible mental health services for youth has become pronounced (Cummings, Wen,

& Druss, 2013; Fazel, Patel, Thomas, & Tol, 2014). An apparent gap in mental health

functioning and access to care among youth, highlights a mental health crisis among

the population. There is a tremendous need for available and culturally appropriate

mental health services for children and adolescents (Algeria, Atkins, Farmer, Slaton, &

Stelk, 2010). In fact, data show that one in five children has a mental disorder and one

in ten children have a serious emotional disturbance that affects their daily functioning

(U.S. Department of Health and Human Services [DHHS], 2001, 2000; Schwartz, 2009).

Despite these troubling statistics, four out of five children who need mental health

services do not receive the help that they need (DHHS, 2000).

There are a multitude of factors that place some children at greater risk for

serious mental health concerns. These risk factors include a family history of mental

and addictive disorders, caregiver separation, abuse and/or neglect, and

multigenerational poverty (DHHS, 1999). Living in urban poverty is especially

associated with stressors that range from child abuse, divorce, violence exposure and

daily hassles that place youth at increased risk for adjustment in elementary school and

psychological problems, including depression (Farahmand, Grant, Polo, Duffy, &

DuBois, 2011; Morales & Guerra, 2006).

Aligned with APA’s Task Force on Resilience and Strength in Black Children and

Adolescents that calls for reframing research to better understand adaptive and

protective factors in the lives of these youth (APA, 2008), this study examines the stress

and coping experiences of Black-identified high school students living in an urban

setting. School-age adolescents were chosen participants because there is evidence of

an association between mental health functioning (i.e., depression), school outcomes

and future life experiences (Fergusson & Woodward, 2002; Roeser & Eccles, 2014)

among this population. Schools are a central cultural context for children and

adolescents, and are an ideal setting for the potential recognition and treatment of

mental health disorders (Fazel, Patel, Thomas, & Tol, 2014; Roeser & Eccles, 2014).

Culture and context have a profound impact on the help-seeking behaviors of youth of

color (Cauce, Domenech-Rodriguez, Paradise, Cochran, Shea, Srebnik, & Baydar,

2002), and schools can intervene and help mitigate the challenges to treatment.

Schools counselors can play an integral role in bridging the gap in the unmet mental

health needs by promoting culturally congruent counseling services for its students.

Studying stress and coping among Black adolescents may help elucidate their

counseling needs and culturally specific factors for providing an arc of support around

the students for optimal social, emotional and academic developmental outcomes.

Urban Stress and Depression

Students living and going to school in an urban setting are of particular interest

because urban stress exposure is strongly associated with depression (Boardman &

Alexander, 2011). Black adolescents with chronic levels of stress reported more anxiety

and depression, were found to engage in antisocial behaviors, and reported less active

coping; whereas adolescents with low levels of stress over time reported fewer

psychological problems, perceived more social support, and were more likely to

graduate from high school than those with higher stress levels over time (Schmeelk-

Cone & Zimmerman, 2003). Black adolescents have a significantly higher risk of

experiencing a peak in stress between the ages of 15 and 17, compared to white

adolescents, which may increase the likelihood for detrimental social and

developmental outcomes (Bennett & Miller, 2006). There is a strong relationship

between family stress, income status, and depressive symptoms among African

American adolescents (Hammack, Robinson, Crawford, & Li, 2004). One study found

that contextual stress in middle school, such as community violence, neighborhood

disorder, and experiences with racial discrimination, was predictive of substance use

for girls, but was associated with aggressive behavior and substance use in high

school for boys (Copeland-Linder, Lambert, Chen, & Ialongo, 2011). Mitigating factors

for boys included high academic competence and self-worth.

Endorsing Africentric values and neighborhood satisfaction are protective factors

predictive of academic self-efficacy beliefs (Shin, 2011). Culturally and contextually

relevant theoretical perspectives provide unique views on the complexities of urban

stress, such as race- or gender-based discrimination, poverty, health disparities,

depression, and coping (Bennett & Miller, 2006; Hammack, 2003; Seaton, Caldwell,

Sellers, & Jackson, 2008). Myers’ (1989) longstanding model of urban stress elucidates

how stressors emerge from the structural society and interact with families,

communities, agencies, and institutions. Myer’s model illuminates how the interaction

between factors, such as race and social class, serve to create a generational pattern of

stress, which complicate the strength inherent in cultural coping resources.

Cultural Coping

Black adolescents in low income neighborhoods with a history of adverse life

events have an increased risk of developing internalizing and externalizing behaviors,

regardless of coping style (Sanchez, Lambert, Cooley-Strickland, 2013). Given the

presence of urban stressors experienced by Black adolescents and the potential mental

health consequences, it is imperative to explore cultural resources that serve as coping

and protective factors in the face of adversity. There is a growing body of literature that

has explored coping among Black adolescents and young adults (e.g., Chiang, Hunter,

& Yeh, 2004; Sanchez, Lambert, & Cooley-Strickland, 2013). According to Murrell

(2002), culturally congruent ways of coping significantly impact the social-emotional

(i.e., symptoms of depression) and academic success of Black adolescents. In this

study, cultural coping is explored through the lens of African-centered worldview, and is

defined as the extent to which adolescents rely on spiritual beliefs or practices,

collective group resources (e.g., family, peers), and creative activities (e.g., dancing,

listening to music, writing poetry) to deal with a recently identified stressful experience.

An African-centered theoretical perspective offers an important framework for

understanding the coping styles exhibited by Black urban adolescents.

African-centered worldview contains three levels of existence—physical, mental

and spiritual selves (Akbar, 1996; Ani, 1997; Caldwell & White, 2001)—and includes the

following nine interrelated cultural dimensions: spirituality, communalism, harmony,

movement, verve, affect, expressive individualism, oral tradition, and social time

perspective (Gallardo, Yeh, Parham, & Trimble, 2011; Myers, 1993; Parham, White, &

Ajamu, 1999). Previous research reveals that African-centered cultural worldview can

promote positive ethnic identity, and beliefs about one’s physical appearance self-

concept (Belgrave, Chase-Vaughn, Gray, Addison, & Cherry, 2000). It has also been

found to serve as a protective factor against drug abuse (Brook & Pahl, 2005).

Cultural coping among Black adolescents, including spirituality, creativity (i.e.,

use of music, song, dance, humor, etc.; Conner, 2003), community resources, and

social and familial support have been documented as protective factors against the

effects of stress and potentially helpful in alleviating mental health concerns (Ripple &

Luthar, 2000; Molock, Puri, Matlin, & Barksdale, 2006). Research has found that Black

youth who place a greater emphasis on spirituality have more positive self-identities and

healthier notions of self in relation (Spencer, Fegley, & Harpalani, 2003). Boyd-Franklin

(2010) also noted that spiritual beliefs are essential to the psychological health and

resilience of many African-Americans and thus should be an essential aspect in the

assessment and treatment processes.

In this study, spiritual coping is explored in the context of the adolescent’s belief

of the supernatural or transcendent power, which may or may not include religious or

communal activities. African-centered worldview and values have been previously

correlated with collective self-esteem and also found to be predictive of stress and

cultural coping styles (Chambers, Kambon, Birdsong, Brown, Dixon, & Robbins-Brinson,

1998; Whaley, 1993). Collective self-esteem (Luhtanen & Crocker, 1992) is

conceptualized as a form of communalism in the present study, whereby adolescents’

self-esteem is intractably connected to their social, ethnic, and collective group identity.

For example, family, community, team related sports involvement, creativity through

music, and peer group relationships, may be dimensions of self-esteem that might be

relevant to the study of African American adolescents (e.g., Dixon, Zhang, & Conrad,

2009). The extent to which adolescents abide by cultural norms and values, and identify

with their social group (e.g., racial, ethnic) may significantly impact their self-esteem,

coping styles, and mental health functioning.

This research study explored the interrelationship between stress, cultural

coping, (which includes spiritual, collective and creative coping) and depression. We

hypothesized a statistically significant relationship between African-centered worldview,

spirituality, collective self-esteem, and cultural coping. These variables were also

hypothesized to be predictive of symptoms of depression.

Method

Participants

Two hundred and eight Black urban adolescents (89 males and 119 females)

between the ages of 14-18 years old (M = 15.74, SD = 1.12) participated in this study.

Representing diverse ethnic groups, the participants self-identified as: 66.8% African

American (n = 139), 16.8% Hispanic (n = 35), and 16.4% Multiethnic or mixed (n = 34).

In terms of grade level, 24.5% (n = 51) were freshmen, 26.4% (n = 55) were

sophomores, 32.2% (n = 67) were juniors, and 16.8% (n = 35) were high school seniors.

While 70% of the school’s population qualified for free lunch, thereby suggesting a

lower-middle class socioeconomic status (SES), a majority of the participants reported a

middle class SES: 7.2% (n = 15) as lower class, 88% (n = 183) as middle class, and

4.8% (n = 10) as upper class. The participants, who were recruited from an urban public

high school in New York City, voluntarily participated and received written parental

consent before participating.

Measures

A total of six measures were used in this study including a demographic

questionnaire, the Children’s Africentric Values Scale (CAVS; Belgrave, Townsend,

Cherry, & Cunningham, 1997), Africultural Coping Systems Inventory (ACSI; Utsey,

Adams, & Bolden, 2000), Collective Self Esteem Scale-Revised (CSES-R; Luhtanen &

Crocker, 1992), Spirituality Scale (SS; Jagers & Smith, 1996), and Reynolds Adolescent

Depression Scale (RADS; Reynolds, 1987).

Demographic questionnaire. A 15-item self-report demographic questionnaire

inquired specifically about the age, gender, race, and ethnicity of the participants.

Children’s Africentric Values Scale (CAVS). CAVS (Belgrave et al., 1997) is a

14-item measure that corresponds to the principles of Nguzo Saba, as celebrated in the

African American Kwanzaa observance. The three subscales are: (a) Collective Work

and Responsibility, referring to the belief of communal support; (b) Cooperative

Economics, representing the belief that resources should be maintained and shared in

the Black community; and (c) Self-determination, corresponding to the belief that Blacks

should strive for achievement as a group. Participants responded to these items on a

three-point Likert-type scale (1 = agree, 2 = disagree, and 3 = not sure). Cronbach’s

alpha was reported at .65; however, validity data have not been reported for this scale.

Following the deletion of the first item on the CAVS, the alpha increased from .47 to .50

for the present study.

Africultural Coping Systems Inventory (ACSI). The ACSI (Utsey et al., 2000)

is a 30-item measure that was developed to gauge the unique coping behaviors

employed by Blacks during stressful life experiences. Respondents are asked to think of

a “stressful situation” and answer questions related to that situation. Items are

responded to using a 4-point Likert-type scale (0 = did not apply or did not use to 3 =

used a great deal). The following three subscales were used in this study: 1) Spiritual-

Centered Coping, 2) Collective-Centered Coping, and 3) Creative-Centered Coping.

The ACSI was modified to include 20 Creative-Centered Coping items. Utsey et al.

(2000) report the alpha coefficients as .79 for Spiritual-Centered Coping, and .71 for the

Collective-Centered Coping subscale. The subscale alphas for the present study are

.80, and .69, respectively; and .84. for Creative-Centered Coping. The total alpha for

this study is .91. Concurrent validity was established between the ACSI and the Ways of

Coping Questionnaire (Folkman & Lazarus, 1985, as cited in Utsey et al., 2000).

Collective Self Esteem Scale-Revised (CSES-R). Luhtanen and Crocker’s

(1992) CSES-R is a 16-item scale that measures the empathic aspects of collective or

social identity by assessing how self-esteem is related to group membership (i.e.,

cultural group). The items are anchored on a seven-point Likert-type scale (1 = strongly

disagree to 7 = strongly agree). The CSES-R includes four subscales of collective self-

esteem: 1) Membership CSE subscale measures how well an individual functions in

their social group; 2) Private CSE is how an individual assesses their group socially; 3)

Public CSE is how an individual thinks others perceive their social group; and 4) The

Importance to Identity subscale measures the role of group membership in one’s self-

concept.

The reported subscale alpha coefficients are .80 for Membership, .90 for Private,

.77 for Public, .80 for Importance to Identity, and .88 for the total revised scale

(Luhtanen & Crocker, 1992). Subscale alphas in the present study are .64, .63, .59 and

.50, respectively. The overall alpha for the CSES-R is .69 in the present study.

Concurrent validity was established with moderate correlations between the CSES-R

and the Rosenberg (1965) Self-Esteem Scale, which measures personal self-esteem

(Luhtanen & Crocker, 1992).

Spirituality Scale (SS). The SS is 25-item scale that measures spirituality

among Black urban adolescents from an Africultural perspective (Jagers & Smith,

1996). The items are responded to on a six-point Likert-type scale (1 = completely false

to 6 = completely true). Five filler items are included for balancing but are not included in

the sum score. Scores are achieved by summing responses to remaining 20 items.

Jagers and Smith (1996) report reliable psychometric properties for the SS scale. The

internal consistency yields Cronbach alpha coefficients of .87 and .84; as well as a 3-

week test-retest coefficient of .88 for the use of this scale in previous research studies.

The total alpha for the SS is .70 in this study. The SS proves to be a valid measure of

spiritual attitudes and beliefs (Jagers & Smith, 1996; Miller, 2001).

Reynolds Adolescent Depression Scale (RADS). The RADS is a 30-item

measure designed to assess depressive symptomatology in adolescents (Reynolds,

1987). The items are responded to on a four-point Likert-type scale (1 = almost never to

4 = most of the time). Seven of the items are inconsistent with depression and are

reversed scored for consistency. Total scores are achieved by summing the responses

to how an individual usually feels. Internal consistency reliabilities range from .92 to .96,

with sample sizes ranging from 44 to 1,050 adolescents. The Cronbach alpha

coefficient is .86 in this study. Criterion-related validity (e.g., concurrent) was

established by examining the relationship between the RADS and another self-report

measure of depression (i.e., Hamilton Depression Rating Scale).

Procedure

Several classes of high school students were introduced to the first author (a

faculty member with a strong background in school counseling) and invited to

participate in this study. Following a question and answer session, adolescents received

an assent form and a parent/guardian consent form, which was completed by their

caregiver prior to participation. There was a high response rate of 98%. A few

adolescents declined, because they, or their parents, did not want them to participate in

the project. The participants completed a survey packet of six measures, which were

counterbalanced to avoid order effects. In order to compensate their participation, they

were entered into a raffle with the chance of winning tickets to a movie or music store.

Survey completion time ranged from 45-50 minutes, and was followed by a debriefing

session.

Results

Preliminary Analyses

There was one qualitative element to this study. On the ACSI, students were

asked to write a brief description of a “stressful situation” that they had encountered

recently. This prompt is primarily used to offer descriptive information about the kinds of

stressful situations Black adolescents are encountering. A preliminary content analysis

of this data results in seven emergent themes of stress that Black urban youth

experience: (a) family and peer relationships, (b) school and career issues, (c) trauma,

loss and sickness, (d) racism and social conflicts, (e) psychological concerns, (f) sexual

and medical health, and (g) spirituality and faith.

Next, an independent-sample t-test was conducted to determine if gender had

significant effects on the adolescent’s African-centered cultural coping styles or on

levels of depression. Significant results were found across gender in both African-

centered coping, t(206) = 2.973, p < .005, and depression, t(206) = 4.595, p < .001.

These results indicate that the boys and girls in this study differ in their reported use of

African-centered coping styles and symptoms of depression. Therefore, given the

possibility of gender differences, the analyses for the independent variables predicting

African-centered coping and depression were run separately. These gender specific

analyses allowed exploration of different associations between African-centered coping

and depression. Preliminary analyses indicated that there were no significant

differences across age or ethnicity.

Correlation Matrix

A correlation matrix of the relationship between the variables used in this study is

provided in Table 1. Internal reliabilities were moderately high for most of the measures,

as the alpha coefficients range from .68 to .86, except for CAVS (α = .50). African-

centered cultural coping was significantly correlated with most of the variables, with the

exception of the CAVS and CSES-R. The correlations ranged from a moderate positive

effect size (r = .50) to a minimal positive effect size (r = .20, p < .01) (Newton &

Rudestam, 1999).

A significant correlation emerged between the variables of spiritual faith, spiritual

African-centered coping (r = .46, p < .01), and collective African-centered coping (r =

.17, p < .05). Moreover, spiritual African-centered coping was moderately correlated

with collective and creative African-centered coping (r = .44, p < .01; r = .48, p < .01,

respectively). Collective and creative African-centered coping were moderately

correlated to each other (r = .55, p < .01). However, there was a significant inverse

relationship between CSES-R and depression (r = -.24, p < .01). Notably, there were no

problems with multicollinearity among the variables in this study.

Table 1

Intercorrelations and Coefficient Alphas of Variables (N = 208)

Variable (# of items) 1 2 3 4 5 6 7

1. CAVS (13) .50 -.086 -.089 -.020 .060 .013 -.010

2. SS (25) .70 .124 .461** .171* .083 .082

3. CSES-R (15) .68 -.041 .018 -.109 -.242**

4. SPIRIT (8) .80 .435** .480** .260**

5. COLL (8) .69 .548** .087

6. CREAT (20) .84 .311**

7. RADS (30) .86

Note. Coefficient alphas are presented diagonally. CAVS = Children’s Africentric Values Scale; SS =

Spirituality Scale; CSES-R = Collective Self-Esteem Scale-Revised; SPIRIT = Spiritual African-Centered

Coping subscale of the Africultural Coping Systems Inventory-Modified (ACSI-M); COLL = Collective

African-Centered Coping subscale of the ACSI-M; CREAT = Creative African-Centered Coping subscale of

the ACSI-M; RADS = Reynolds Adolescent Depression Scale.

*p < .05. **p < .01.

Simultaneous Regression Analyses

Simultaneous regression analyses were performed to further explore the strength

of the association between the variables under study. First, we hypothesized a

significant relationship between African-centered worldview, spirituality, collective self-

esteem and cultural coping (which includes spiritual, collective and creative coping).

This hypothesis was only partially supported by the data. The independent variables,

African-centered values/worldview, collective self-esteem, and spirituality predicting the

dependent variable, spiritual African-centered coping, were statistically significant for

girls (t

118

= 5.51, p < .001) and boys, (t

= 5.16, p < .001), indicating that 21.3% and

25.5%, respectively, of the total variance in spiritual African-centered coping was

accounted for by the independent variables (see Table 2).

Table 2

Simultaneous Regression for Variables Predicting Spiritual African-Centered Coping by Gender

(N =208)

Variable B SE B



Girls (n = 119)

CAVS 5.340E-04 .139 -.032 -.385

SS .227 .041 -.465 5.507***

CSES-R -2.218E-02 .040 -.047 -.556

Boys (n = 89)

CAVS 9.141E-04 .186 .048 .492

SS .189 .037 .486 5.162***

CSES-R -6.649E-02 .039 -.167 -1.727

Note. CAVS = Children’s Africentric Values Scale; SS = Spirituality Scale; CSES-R = Collective Self-Esteem

Scale-Revised.

*p < .05. **p < .01. ***p < .001.

While the variables predicting collective African-centered coping approached

significance for girls, they were not statistically significant for either gender. Finally, the

variables under study were not predictive of creative African-centered coping.

Our second hypothesis that African-centered worldview, spirituality, collective

self-esteem and overall African-centered coping would predict symptoms of depression

was fully supported by the data (see Table 3). Gender, African-centered worldview,

spirituality, collective self-esteem, and African-centered coping significantly predicted

depressive symptoms among Black adolescent in this study, (t

207

= 4.32, p < .001). The

variables collectively accounted for 21.2% of the total variance.

Table 3

Simultaneous Regression for Variables Predicting Depression (N =208)

Variable B SE B



Gender 6.90 1.60 .278 4.32***

CAVS -.196 .261 -.047 -.749

SS 4.860E-02 .068 .046 .711

CSES-R -.244 .066 -.233 -3.67***

ACSI-M .156 .051 .202 3.03***

Note. CAVS = Children’s Africentric Values Scale; SS = Spirituality Scale; CSES-R = Collective Self-Esteem

Scale-Revised; ACSI-M = Africultural Coping Systems Inventory-Modified.

*p < .05. **p < .01. ***p < .001

Discussion

Cultural Coping

We found that African-centered worldview, collective self-esteem, and spirituality

predicted the use of spiritual coping across gender. Consistent with previous theory and

research (Mattis, & Jagers, 2001), this finding suggests that spirituality and religiosity

are culturally appropriate practices for dealing with stress and risk behaviors among

Black urban adolescent (Moore-Thomas & Day-Vines, 2008; Steinman & Zimmerman,

2004). Similarly, among African American female college students, social support,

spirituality, and an optimistic belief system were utilized to cope with negative situations

(Hill, 2010). Adolescents in this study reported using collective coping styles to cope

with stress, but the use of such strategies only approached significance for girls. This

effect might be accounted for by possible developmental effects, in that youth might

experience discomfort in talking to others about the stress in their life, and choose

alternative, more spiritual or nonverbal ways of coping with urban stress and challenges

in daily living (e.g., prayer).

Consistent with African-centered ways of coping, the adolescents also reported

using creative ways of coping with urban stress. Adolescents are increasingly being

drawn to dance, drama, and humor as means of coping and gaining group affiliations

(Harris, 2007). Creativity continues to be a successful component of school and

community programs implemented to increase ethnic pride among youth of color, who

are coping with urban stress, migration, and discrimination (Murrell, 2007). African

American storytelling can be used as a narrative and performance-based strategy of

resistance, healing, and coping for the narrator as well as spectators (Edwards, 2010).

School counselors should consider ways to promote strengths and cultural coping

resources to mitigate possible mental health consequences from urban stress, such as

symptoms of anxiety or depression.

Mental Health and Depression

The hypothesis that African-centered coping would predict symptoms of

depression was significantly supported by the data in the expected directions. The

adolescents who reported greater symptoms of depression used spiritual and creative-

centered practices to cope. Similar to findings by Schmeelk-Cone and Zimmerman

(2003), students with greater connections to their collective group, peers, and family

reported fewer symptoms of depression. It is noteworthy that on symptoms of

depression, the adolescents in this study scored one standard deviation above the

mean compared to the original normative sample of Black high school students

(Reynolds, 1987), which may reflect greater experiences of perceived stress.

Limitations

There are several limitations that should be noted. Given the use of a correlation

design, causality cannot be determined and internal validity is threatened. In addition,

participants were not randomly selected in this study and are specific to a northeastern

urban location. Hence, they are not representative of all adolescents. The participants in

this study might cope in fundamentally different ways than other Black adolescents

living in other urban, suburban or rural areas due to a variety of factors, such as cultural

worldview, identity or resources available to them.

Implications for School Counselors

Our findings reveal that African-centered worldview, collective self-esteem and

spirituality are predictive of cultural coping practices. Adolescents in our sample coped

with depression in spiritual and creative ways. Notably, adolescents with strong family

and peer support reported fewer symptoms of depression. This study has implications

for school counseling in an environment that encourages interdisciplinary collaboration

and teamwork to build emotional wellness.

School counselors, in collaboration with teachers, administrators, psychologists,

and social workers, must be committed to supporting students’ culturally specific coping

practices. Honoring and developing students’ cultural assets and worldview may help

mitigate symptoms of depressions by providing coping resources. Academic lesson

plans and counseling interventions based on cultural coping strategies that are

psychosocial in nature, may assist in promoting healthy adaptive behaviors, enhancing

social support with peers, and integrating key family members or social network (e.g.,

friends) in the treatment.

Counselors have the potential to be leaders and advocates responsible for

working together to benefit students, parents, teachers, administrators and the overall

community (Pellitteri, Stern, Shelton, & Muller-Ackerman, 2006). Mental health

consultation and collaboration with community agencies and institutions such as

churches are integral (Queener & Martin, 2001). Ultimately, psychoeducation,

prevention, and treatment programs must be culturally sensitive and contextually

appropriate to meet the needs of black adolescents in urban settings, and destigmatize

mental health treatment. Focusing on helping black-identified adolescents build positive

identities is recommended, as group identification has been found to foster one’s belief

in their ability to cope effectively and predict a positive well-being (Outten, Schmitt,

Garcia, & Branscombe, 2009; Williams, Aiyer, Durkee, & Tolan, 2014). Cultivating family

connectedness, spiritual faith, and creative healing are all recommended for cultural

coping skills development.

Consistent connections between positive styles of religious/spiritual coping and

better mental health outcomes, such as shorter remission of depression, less anxiety

and increased affect, are highlighted in the theory, research, and practice (Hefti,

2011; Ferraro & Koch, 1994; Koenig, George, & Peterson, 1998; Pargament, 1997,

2002; Pargament, Koenig, & Perez, 2000). Similarly, the use of creative art exercises,

music and movement, poem/spoken word writing, collage building, and collateral

sessions with a close friend or family present in the session for social support, to be

helpful in fostering culturally appropriate treatment among African American students

(Querimit & Conner, 2003). Other approaches may integrate meditation, inspired

readings, and group support.

Viewing youth through a cultural lens that locates their emotional and behavioral

presentation at the intersection of urban stress, social inequalities, health disparities,

and oppression provides awareness and a necessary framework for therapeutic

progress and positive youth development outcomes (Grills, Cooke, Douglas, Subica,

Villanueva, & Hudson, 2016). In sum, school counselors can help establish a healthy

foundation for building alliances, empowerment, change and therapeutic intervention in

work with Black adolescents. In addition, they can help foster positive identity

development, strengths and flexible coping not only on an individual level but in schools

and other community contexts as well (Querimit & Conner, 2003; Varas-Díaz &

Serrano-García, 2003; Watts & Serrano-García, 2003; Watts, Williams, & Jagers, 2003),

which may help to mitigate depression in this population. Educating students on how to

cope with and manage the detrimental effects of stress may reduce the need for

treatment interventions (Nelson & Tarabochia, 2017).

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Biographical Statement

Latoya C. Conner is an associate professor in the Department of Psychiatry &

Behavioral Sciences at Stanford University School of Medicine. She specializes in the

treatment of depression, anxiety, grief and trauma among children, adolescents and

adults. At the college level, she provides treatment and intervention for first generation,

low-income and international students. Trained as a psychologist in pediatric, legal and

school settings, she has a special interest in school-based mental health and wellness,

health promotion and prevention initiatives. She is an expert witness on child abuse

cases in California and New York State. Correspondence should be addressed to:

Latoya C. Conner, 401 Quarry Road, Stanford, CA 94305, Phone: (650) 736-9211, Fax:

(650)-723-9807, email: [email protected]

Christine Yeh is professor of psychology and education in the Department of

Counseling Psychology at the University of San Francisco. Her interests include school

counseling interventions for cultural empowerment, equitable futures, and college

access. She is currently principal investigator of large scale project implementing and

evaluating 45 college access programs for middle and high school students in the San

Francisco Bay Area. Dr. Yeh can be reached at the University of San Francisco, School

of Education, 2130 Fulton Street, San Francisco, CA 94117, Phone: (415) 422-2347,

Fax: (415) 422-5527, email: [email protected]

The authors would like to acknowledge that this research was funded by the

Spencer Foundation.