BLESSING OKORO RELLIAS, PHD MARVA BOURNE, DMFT (PERRIS VALLEY RECOVERY PROGRAM, INC) Cultural Competency in Schools

CBITS Cognitive Behavioral Intervention for Trauma in Schools Evidence Based Practice (EBP) that provide clinical guidance for the work we do. Originally developed while working with immigrant populations. Based on core Cognitive Behavioral concepts and interventions.

CBITS – Cultural Adaptation in Implementing Program Screening: Brief and culturally sensitive Sessions 1 & 2: Reduce stigma, build support and communication Sessions 3 & 4: Expression of anxiety, ability to observe own thoughts, challenging cognitive distortions Individual Sessions: Exposure to trauma memory Sessions 5: Family attitude towards trauma Sessions 6 & 7: Cultural practices of story-telling and narratives (be mindful of any story-sharing complications) Sessions 8 & 9: Social problem solving, brainstorming as a group, community/resource building Session 10: Graduation & Relapse prevention

What is Culture? A defining element across the domains in which prevention operates (individual, family, peer, school, community, and society)

CBITS – Cultural Adaptations Use examples that the children/families can relate to Address cultural concerns that may affect treatment Use knowledge of the population’s cultures Be aware of countertransference and concerns regarding the use of CBITS with minority populations

Culture of the Schools Administrators  Staff  Teachers  Students Students  Peers Practioners:  Advocate for students  Empower students  Impartial and nonjudgmental

Culture of the Environment Environment  Migration from Los Angeles to escape gang lifestyle  Seek better life for children  More affordable homes  Single parents/parents working far from home Gang involvement  Youth  Violence Drugs and Alcohol  Parents and youth  Easy availability

Cultural Effects on Mental Health GIRLS Factors that contribute to Early Pubertal Development (Belsky et al, 2007) Absence of father in home Stressful rearing environment Insecure attachment to parents Harsh parenting

Early Pubertal Development Early Pubertal Development leads to:  Shift in social environment  Increased conflicts with family, peers, and authority figures (Remschmidt, 1994)  Low self-image and self-esteem dissatisfaction with potential risks for accelerated sexual behavior, pregnancy, and sexually transmitted diseases (Doswell, Millor, Thompson, and Braxter, 1998)  Emotional problems and engagement in high-risk behaviors such as smoking and early initiation of sexual activity compared with their peers (Ellis, 2004)

Antecedents to Violence in Boys BOYS Abandonment by father Toxic shame Abandonment by mother Mother choosing her partner over welfare of children Mother’s boyfriend – high risk factor Mother seen as weak – unable to care for herself. Therefore, children take overprotective role.

Antecedents to Violence in Boys (Cont’d) Child abuse (35% of abused children turn violent – Garbarino) Lack of community resources  Presence of mentor or loving adult can play a saving role  Powerful adults who could steer them away from violent role models are absent

Social Outcomes Truancy and failing grades Violence (Domestic, gang membership)  Hopelessness  Need to protect Child Protective Services involvement Placement with foster families  Resentment toward system  Reunification issues  Foster family may not be African-American but White or Hispanic