Empowerment Pathways: A Mitigation Approach to Adolescent and Youth Racial Stress in Marginalized Populations

Racial unrest recently has been incessant. In response, this conceptual contribution explores a prevention-based program for African American adolescents and youth to aid in their navigation through ubiquitous racial unrest and persistent mental health adversities. This article provides a comprehensive literature review on racial injustice and presents information regarding race-based traumatic stressors and adverse mental health outcomes. The prevention-based program that was created in response to the apparent racial unrest among African American youth and adolescents is presented and explored. The goal of this conceptual article is to raise awareness of this issue, provide practical steps to combat racial injustice, and increase prevention initiatives.


Introduction
The resurgence of sociocultural racial unrest provides newfound pertinence to revisit the significant effects of racial traumatization on the mental health of African American youth and adolescents (Tynes et al., 2019). The World Health Organization (WHO, 2021) has defined adolescents as individuals who are 10-19 years old and youth as individuals who are 15-24 years old. Because media is an interactive part of current life, African American adolescents and youth have been continually exposed to media coverage highlighting racial discrimination and possible systemic dangers (Heard-Garris et al., 2018;Range et al., 2018). African American youth and adolescents might present with hidden wounds emerging from racial trauma, including sentiments of internalized devaluation, an assaulted sense of self, internalized voicelessness, unfathomable rage, and deep-seated wrestling with a sense of being a nobody (Hardy, 2013).
It is imperative that the adverse mental health outcomes of African American youth are acknowledged and addressed, while also understanding and combating the oppression that lingers. Racial oppression accounts for "a traumatic form of interpersonal violence which can lacerate the spirit, scar the soul, and puncture the psyche" (Hardy, 2013, p. 25). An ailment of racial oppression is frequently the difficulty Black, Indigenous, and persons of color (BIPOC) communities face with descriptively conveying their realities to others outside of the shared community due to concerns of minimization or disbelief from non-BIPOC groups, posing hurdles to healing (Hardy, 2013;Saleem et al., 2019). Although trauma is known to cause many disparities and inequitable mental health issues, this is often explored in terms of intervention techniques, rather than prevention and mitigation techniques and initiatives.

Journal of Human Services
Fall 2021 Racial trauma can produce long-term emotional scarring, resulting in chronic measurable stress, anxiety, and trauma symptoms (Heard-Garris et al., 2018;Morsy & Rothstein, 2019;Williams et al., 2018). Specific to African American youth and adolescents, reactions exhibited in response to traumatic stressors and events can include thought intrusion; avoidance responses; irritability (i.e., hyperarousal); and emotional responses of anger, rage, shame, guilt, anxiety, grief (i.e., sorrow), and depression on account of emotional injury (Carter, 2007;Heard-Garris et al., 2018;Morsy & Rothstein, 2019). The aforementioned factors necessitate the consistent use of a social justice perspective to combat these issues in their entirety.
It is essential to recognize the importance of incorporating trauma-informed therapeutic supports, concurrent with multicultural competent strategies, into therapy for African American youth to heal interpersonal and racial trauma (Metzger et al., 2020;Ratts et al., 2016). When considering the racial trauma and race-based traumatic stressors, systemic, structural, and social hindrances to social determinants of health (SDOH) can significantly hinder the comprehensive growth and functioning of African American youth (Svetaz et al., 2014). A collaboration between support services and socio-political advocacy are needed to create the optimum environment for racial empowerment in the African American youth community (Devia et al., 2017).

Literature Review
Generally, hallmark developmental tasks for youth and adolescents involve cultivating socialization skills, together with pronounced attention toward developing friendships, navigating peer interactions, adjusting to physiological changes, and negotiating independence (Berk, 2014;Brittian, 2012;Derlan & Umana-Taylor, 2015). In conjunction with these developmental demands, African American youth and adolescents in the United States encounter complex sociocultural adaptations and experiences stemming from racial prejudice, violence, and normative stereotyping (Brittian, 2012;Sue & Sue, 2016). Findings from a study conducted by Seaton et al. (2010) point to discrimination attributable to physical appearance among African American adolescents, spurring elevated depressive symptoms and concerns with self-esteem if viewed separately from discrimination as attributable to one's race or ethnicity.
For African American youth and adolescents, the existing literature identifies factors of affirmation-belonging with a cultural groups as enhancers for positive self-esteem, self-image, academic adjustment, and interpersonal functioning (Derlan & Umana-Taylor, 2015). Affirmation-belonging for African American youth and adolescents also mitigates mental health concerns (e.g., depression), substance use, and other concerning behavior (Derlan & Umana-Taylor, 2015). Maternal support, coupled with racial socialization, prominently contribute to racial identity formation in African American youth and adolescents (Wang, 2011).
Gender differences in African American youth and adolescents are also seen when exploring the intersectionality of self-image and identity formation. Relying on binary gender categories, the literature suggests that exposure to intersecting racism and sexism is a pressing developmental consideration for African American adolescent females, whereas gender identification largely overlaps for African American adolescent males (Rogers et al., 2015;Sue & Sue, 2016). Still, continuing with binary gender descriptions, African American female and male youth and adolescents exhibit congruence in heavily weighing racial identification above gender identification (Rogers et al., 2015;Sue & Sue, 2016), notably due to a prevalent belief in the necessity to "overcome obstacles resulting from societal misperceptions involving Blackness" (Sue & Sue, 2016, p. 472). Research reflects a correlation between high racial centrality (i.e., "the extent to which an individual normatively emphasizes racial group membership as part of their overall self-concept"), positive school attitudes, and academic achievement in African American male youth and adolescents (Scottham et al., 2008, p. 298;Wang, 2011). Racial centrality in African American female youth and adolescents affords a protective factor against peer influences on their academic self-concept (Wang, 2011).

Racial Trauma in Focus
African American youth and adolescents often encounter direct and vicarious forms of trauma through the intersectionality of race identity, systemic discriminatory practices, and implicit societal biases, regardless of socioeconomic status (Svetaz et al., 2014). Targeted violence towards BIPOC individuals unearths daily parental concerns for the welfare of African American children with intensified distress over the safety of African American youth and adolescent males (Bryant-Davis et al., 2017). Historical trauma, stemming from generational grappling with the atrocities of enslavement in the United States, the enforcement of cultural segregation and disenfranchisement during the Jim Crow Era, and the insurgence of racial brutality during keystone civil rights developments, linger as contextual variables framing the experiences of today's African American youth and adolescents. The transferable implication of historical trauma is the prevailing cross-generational traumatic stress shared by the African American community: relived, rehearsed, and triggered by present-day racial injustices and unrest (National Child Traumatic Stress Network, 2017).
When viewing racial trauma through the lens of post-traumatic stress disorder (PTSD), the implications of racial trauma bind African American youth and adolescents to cyclical manifestations of "profound disempowerment," coupled with compounded "impactful risks and disadvantages" (Compton & Schoenberg, 2021, p. 56). Further, social, systemic, and structural reinforcements of disempowerment have the propensity to endure across generations (Compton & Schoenberg, 2021). Racial trauma produces toxic stress and hormone disruption, severely hindering adequate brain functioning and development, spurred by stunted prefrontal cortex activity (Morsy & Rothstein, 2019). Predisposition to early-age and later-life risks for health problems like high blood pressure, heart disease, metabolic and immune system compromises, and infections are influenced by ethnicity (Heard-Garris et al., 2018;Morsy & Rothstein, 2019). Interpersonal, emotional, behavioral, and academic concerns are additive risk factors produced by racial trauma experiences (Benner et al., 2018;Metzger et al., 2020). Persistent race-based distress and vicarious racial trauma exposures can heighten the susceptibility of African American youth and adolescents to develop long-term post-traumatic stress symptomology (Metzger et al., 2020). These factors, together with crippling rehearsals of self-inadequacy through racial injustice encounters, point to preventable consequences of racial trauma via empowerment-based narratives and action steps.

Rationale for Mitigation and Empowerment Initiative
Ideally, the integration of racial socialization resiliency skill-building into empowerment programming for African American youth and adolescents affords could mitigate direct and vicarious traumatic stressors and increase wellness for this population. Racial socialization incorporates messages on "racial pride, barriers, equality, and achievement," redirecting race-based traumatic experiences and mirroring resiliency messages derived from African American caregivers (Metzger et al., 2020, p. 2). Racial socialization functions as an influential mitigator of depression, stress, and behavioral and psychological concerns, while enhancing self-esteem, coping skills, and inner resourcefulness amid stress-inducing sociocultural events (Metzger et al., 2020). Further, holistic (i.e., mind, body, and spirit) self-care promotion serves as a protective and preventive factor against race-based traumatic stressors (Mental Health America, 2020).
Within the community interventions for African American youth, the importance of instilling positive community contribution and engagement, psychoeducation, and related opportunities, as well as collaboration with trusted adults on cultural advocacy, is a vital part of mitigation and resiliency development in younger generations (Kim et al., 2016). Thus, using the Albee's incidence formula as a guide, the "Acknowledge & Empower" presentation offers a mitigation-based approach for vicarious racial trauma in African American youth and adolescents. This presentation contains several resources for African American youth and their caregivers, with subsequent sections further detailing the presentation structure and contents.

Acknowledge and Empower Presentation Overview
The urgency to develop mitigation-based programs for African American youth to help them navigation through ubiquitous racial unrest and persistent mental health adversities is boldly apparent. The community expects providers to join forces with professionals and organizations to combat the current reality for African American youth. Our team responded to this need by creating a mitigation-based approach to address racial trauma in African American youth and adolescents. Our psychoeducational and empowerment-based mitigation presentation, Acknowledge and Empower, contains content adaptable for preteen and teenage groups. The purpose of this presentation is to inform, educate, and empower African American youth and teens, about racial injustice and secondary trauma. During the creation and refinement of this presentation, practitioners should focus on shifting from a problem-oriented narrative to a strength-based, culturally competent, and psychoeducational direction for dealing with traumatic stressors within this population.
The sections within the presentation were intentionally designed to provide general and specific information on the topic, offer valuable insight, introduce effective and helpful mental health techniques, and provide valuable resources and recommendations. It is important to mention that although this was a recorded presentation, it was interactive and engaging. Prevention and mitigation related to race-based traumatic stressors and African American youth is imperative (Sellers et al., 2013). The program was strategically divided into six sections: (a) What is Racial Trauma and Injustice?; (b) Let's Talk About Diversity and Justice; (c) Understanding and Healing Racial Hurts; (d) Dealing with Stress; (e) Embrace, Encourage, and Empower; and (f) Resources.

What is Racial Trauma and Injustice?
The first section of our presentation served as the foundation for the Acknowledge and Empower presentation. This section introduced various terms to which participants might have been exposed, but which they may not have fully understood, such as racial injustice, systemic racism, trauma, secondary trauma, and insidious trauma. Although these terms were explained in a general sense, the explanations that accompanied them were all-inclusive and descriptive, in an effort to promote full understanding. The second half of this section Fall 2021 focused on the importance of this information and mitigation tool. We presented the explanation of racial injustice being imperative to explore and combat the specific effects it had within the African American community (Heard-Garris et al., 2018). This was followed by an exploration of the adverse effects that racial injustice and traumatic event exposure have on the mental health of African American youth (Tynes et al., 2019). We also discussed the mental health of African Americans related to racial mistreatment, depression, anxiety, stress, and trauma symptoms (Assari et al., 2018;Collins et al., 2010;Williams et al., 2018) and explained in an evidence-based fashion. Although these facts were presented to ensure an understanding of the negative effects that can potentially surface, the comprehensive explanations solidified the importance of prevention and mitigation tools for African American youth.

Let's Talk About Diversity and Justice
The second section began with a comprehensive and relatable explanation of terms that were pertinent to this presentation: identity, diversity, equity, and justice. This information was important to explore because these terms can easily be misinterpreted (Velliaris & Pierce, 2017). We then streamed two videos about embracing diversity, which depicted diversity from a positive perspective, exemplifying the ways in which diversity can be embraced. These videos provided an interactive modality to strengthen awareness on this important and timely topic (Blackstock et al., 2017). Next, we discussed ways individuals can care for others through justice. This included an explanation of the importance of justice as well as how this might be practiced in real time. Several examples were presented for how participants can practice justice: respecting all people, assisting others who are experiencing instances of injustice, and being inclusive during activities. This was further explored through comparing and contrasting injustice and justice to provide a more thorough understanding of how this might occur in daily life. Additionally, two videos for each age group were included and discussed, showing examples of caring for others. This section concluded with an experiential activity, which included pausing to think about various questions, such as: 1. What makes you unique? 2. What does equity mean or look like to you? 3. What ways do you practice justice towards others?

Understanding and Healing Racial Hurts
The third section of our presentation began with an invitation, "together let's break this cycle of hurt!" (Robins et al., 2020). Inviting youth to be a part of opportunities for positive community engagement is vital for mitigation and resiliency development in younger generations (Kim et al., 2016). Next, we described increased risk factors for secondary trauma, including lack of support, secondary exposure to traumatic stories, lack of self-care, and previous trauma. Psychoeducation on emotional, physical, behavioral, professional, cognitive, spiritual, and interpersonal effects of trauma followed, with an invitation to seek help if youth identified symptoms in their own experiences. Finally, the presentation challenged youth to practice wellness through developing a lifestyle inclusive of balanced nutrition, quality sleep, supportive relationships, mental healthcare, physical activity, and mindfulness practices.

Dealing with Stress
The presentation shifted to a detailed section on dealing with stress, specifically developmental skill-building techniques and participatory action to adversity. Gaylord-Harden et al. (2018) point out two essential components in response to threats on wellbeing: adaptive calibration and positive youth development. Adaptive calibration, or intentionally modifying a stress response, requires awareness of human automated stress response (Gentry, 2016). Psychoeducation and body regulation are indispensable components for trauma recovery (Compton & Schoeneberg, 2021;Gentry et al., 2017, Kezelman & Stavropoulos, 2019. We provided basic education on the body's stress response system and invited youth to practice three coping strategies: relaxation, breathing, and mindfulness to increase body awareness; identification of safe places; and monitoring stress through an adapted version of Wolpe and Lazarus's subjective units of distress (Compton & Schoeneberg, 2021). These activities aimed to increase awareness and provided opportunities for youth to respond with action to felt threats. Finally, a focus on positive youth development is critical (Gaylord-Harden et al., 2018). Youth identified and reflected on hope and strength narratives personally and within their communities. Several authors point to developing and emphasizing stories of hope and resilience as essential components of mitigation and recovery (Gaylord-Harden et al., 2018;Gentry, 2016;Metzger et al., 2020;Walsh, 2007).

Embrace, Encourage, and Empower
Along with the focus of building an understanding of secondary racial trauma along with stressor coping skills, a positive psychology section within the Acknowledge and Empower presentation was implemented. This section was integrated as an important intervention for the African American youth community in trauma resiliency (Walsh, 2007). The resiliency development highlighted in the Embrace, Encourage, and Empower section built protective factors for African American children and adolescents for current and possible future trauma. The content focused on the message of pride in identity, as well as actively and positively engaging within local communities.
We shared empowering narratives of successful African American youth who have positively counteracted racial messages and contributed to their communities. These children and adolescents not only sought success, but also provided resources and a voice to youth in crisis (Hill, 2018). We also provided positive engagement examples, such as facilitating a virtual book club that focuses on racial inequity or local community beautification activities. This was paired with a psychoeducation portion on self-care and wellness to reduce toxic stress, including physical activity, emotional expression techniques, and supportive peer relationships. Finally, the presentation facilitated an exercise to build a personalized self-care and wellness plan. This experiential activity modeled self-care planning for children and adolescents as well as reinforcing coping mechanisms that assist in resiliency from racial trauma stressors.

Resources
The last portion of the presentation focused on equipping youth with accessible resources in the continuing response to secondary racial trauma. These included virtual resources and ideas for building in-person support. We chose to include these resources to reinforce resiliency for youth through outreach components. Online assistance was provided in order to continue discussion on the topics of diversity, racial trauma, empowerment, and advocacy engagement. Sites for psychoeducation on healthy coping resources were equally provided for child and adolescents continued learning and skill-building. Tangible ideas for safe outlets and community engagement were also given to assist youth with identifying safe adults in their local environment. All of these available recommendations seek to empower children and adolescents in the African American community with tools to learn, act, and engage in their wellness and response to racial trauma stressors.

Limitations
The sensitive nature of this topic would benefit greatly from onsite facilitators to therapeutically process this presentation and youth responses as needed. Although the program is possible through pre-recorded video, the value of in-person staff inviting youth to participate, engaging youth in group discussion, and asking youth to consider the topics through dialogue, cannot be overlooked. In addition, in-person facilitators should be prepared to monitor youth reactions and provide counseling referrals for those who disclose exposure to trauma, mental health symptoms, or desire further opportunity to process the material. COVID-19 restrictions delayed the launch of our program, and limited some of our anticipated plans. Although we pre-recorded the presentation material for an organization for adolescent and youth, interruptions prevented a successful launch of this program. Plans for wider distribution and further research specifications for the presentation remain in progress.
The organization requesting this program asked that curricula be relevant for youth ages 10-18; however, we recommend separate programs for a middle school audience and high school audience to ensure a developmentally appropriate focus specific to each age group. Potential limitations for a combined group include differences in insight, exposure, and interest level. Youth will benefit from activities and group discussions tailored to their age group. Much of the research and language for this presentation focused on African American youth; however, other minority groups can equally benefit from the topic and discussion. Efforts to use language inclusive of all racial and ethnic minorities would broaden the impact of the program.

Implications for Future Research
Future research should investigate the effects of perceived systemic discrimination and racial trauma on community demographics. More specifically, there should be continued research on the effects of primary and secondary racial trauma for African American children and adolescents as well as other minority populations. More evidence-based research on racial discrimination and its effects on developmental identity is a necessity when considering improving methods of services for African American youth (Seaton et al., 2011). In addition to racial injustice, SDOH for African American youth and adolescents should be considered and explored, as they can contribute to adverse mental health outcomes and worsened traumatic stressors (Sederer, 2016). Research should also focus on the development or refinement of tools used to assess and identify the frequency and severity of adverse health outcomes for African Americans who respond to vicarious racism exposure (Heard-Garris, 2018). Proven measures identifying exposure sources would also provide advocacy for further prevention and mitigation targets. This investigation could lead to increased evidence-based response modalities.
There is an apparent gap for the use of evidence-based mitigation methods for the African American demographic (Kogan et al., 2016). This highlights the need for continued research to identify the needs for the population's youth, as well as development of practical and effective preventative methodologies. In alignment with developing evidence-based prevention programs is the need for evidence-based training for community providers. This increases the integrity and consistency of program delivery for receiving youth and provides fidelity to the program for continued evaluation and modification (Kogan et al., 2016).

Conclusion
It is increasingly apparent that although this mitigation method is a step in the right direction, it is not exhaustive and far from being a simple fix for the prevalent issues of racial injustice among African American youth. The mitigation plan we have discussed has the potential to be adaptable, comprehensive, and multiculturally-responsive in nature. Our intervention provides a way to address these issues within clinical settings and community and school programs. Although this must be executed carefully and strategically, the abundance of research and resources provides a solid foundation for making this an ideal option (Alvarez et al., 2016;National Child Traumatic Stress Network, 2017). Overall, when comparing various clinical formats, group counseling is one especially effective way to collectively target racial injustice, systemic racism, mental health equity, and multidimensional identities (Hope et al., 2020;Metzger et al., 2020;Vereen et al., 2020). Although some issues naturally might be better-suited to individual services, our reading of the literature is that group counseling has the potential to be effective when used to address the types of issues discussed in our article by providing a collective and empowering framework.
Turning to implementation, we believe that community social programming for African American youth and teens (like that of The Boys and Girls Club of America or YMCA) will be especially open to the types of prevention and mitigation initiatives we have outlined-and that these social programs have the willingness and capability to assist and engage with human services. For example, The Boys and Girls Clubs of America (2020) consistently mentions condemning racism, boldly advocating for change, and standing behind an equitable and inclusive standpoint. Additionally, the YMCA (2020) seamlessly aligns with similar values and objectives. For this reason, we strongly believe that the integration of mitigation presentations and programs could be effectively and successfully carried out in these programs across the United States. In conclusion, the Acknowledge and Empower presentation plants a seed of intergenerational resiliency at the onset in which racial trauma and racial stressors first emerge with deleterious impressions. Through buildable momentum and radical hope for change, Acknowledge and Empower seeks to strengthen the current generation of advocates in their quest for equity, justice, and fairness across sociocultural dimensions.