Anti-Black Cultural Racism Hinders the Benefits of Youth Psychotherapy Interventions

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August 18, 2021

2 minute read

Source/Disclosures

Disclosures: Price reports receiving grant or research support from the American Psychological Foundation, the Boston College School of Social Work Center for Social Innovation, the Boston College Schiller Institute for Integrated Science and Society, and the Pershing Square Fund for Research on the Foundations of Human Behaviour. Please see the study for relevant financial information from all other authors.


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According to the results of a meta-analysis, youth psychotherapy interventions with predominantly black samples were significantly less effective in communities with higher anti-black cultural racism.

“Although it is theorized that addressing sources of stress in minority individuals – including racism – improves the effectiveness of interventions for marginalized groups, there has been surprisingly little research on whether racism moderates the heterogeneity of treatment effects”, Maggi A. Price, PhD, a psychology associate in the psychology department at Harvard University, and his colleagues wrote in Journal of the American Academy of Child and Adolescent Psychiatry. “In the present study, we fill this gap by examining whether mental health interventions with predominantly Black samples are less effective in communities with higher levels (compared to lower levels) of anti-Black cultural racism.”

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The researchers conducted a systematic search to identify a subset of 194 studies with 14,081 participants aged 2 to 19 from an earlier meta-analysis of randomized controlled trials of youth psychotherapy that were published in English between 1963 and 2017. Included studies were conducted in 34 states. and included 2,678 effect sizes that measured the mental health problems, such as depression, targeted by the interventions. Price and his colleagues used a 31-item composite index measuring explicit racial attitudes, which they obtained from publicly available sources like the General Social Survey, to operationalize anti-black cultural racism. They aggregated items at the state level and linked them to the meta-analytic database. The samples included in the analyzes included 36 studies with 50% or more black youth and 158 studies with 50% or more white youth.

Controlling for area-level relevant covariates, results from two-level random-effects meta-regression analyzes showed an association between higher anti-black cultural racism and lower effect sizes for studies with predominantly black youth (beta=0.2; 95% CI, -0.35, -0.04); however, higher anti-black cultural racism was not associated with effect sizes for studies with predominantly white youth (beta = 0.0004; 95% CI, -0.03, 0.03) . Mean effect sizes were significantly smaller in states with the highest anti-black cultural racism compared to states with the lowest racism in studies of majority black youth.

“Our study makes a new contribution to this literature by suggesting a previously overlooked way in which anti-Black racism, measured at the macro (cultural) level, can negatively impact the mental health of young Black people – by undermining their ability to benefit from psychotherapy interventions,” wrote Price and colleagues. “In doing so, our findings also open new avenues for future research at the intersection of cultural racism, developmental science, and health interventions. mental.”

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