Nonsuicidal Self-injury and Barriers to Accessibility of Dialectical Behavior Therapy Among Black Youth

A Systematic Review and Meta-Analysis: Psychotherapy Interventions for Reducing Suicidal Thoughts and Behaviors Among Black Youth

OBJECTIVE

Suicides continue to increase among youth, with substantial disparities among Black youth. Culturally responsive evidence-based interventions for Black youth are urgently needed to disrupt these inequities. This study aimed to identify evidence-based psychotherapy interventions for suicidal thoughts and behaviors among Black youth and examine how existing intervention manuals have integrated culturally relevant content to Black youth.

METHOD

Literature searches were conducted to identify relevant articles comparing the effectiveness of interventions for suicidal thoughts and behaviors in study populations including >30% Black youth and youth participants up to age 25. Published articles and therapy manuals were analyzed on cultural adaptation and on 7 content domains for cultural adaptation. Meta-analysis used a random-effects model and explored potential moderators.

RESULTS

Of 755 screened records, 13 studies met eligibility criteria and featured 8 manualized interventions. Meta-analysis revealed significant effects in reducing suicidal thoughts and behaviors between treatment groups (Hedges g = 1.08 with 95% CI [0.07, 2.09]), but low-quality evidence, significant heterogeneity, small sample sizes, and inconsistencies in outcome measures. Only 1 intervention, Adapted Coping With Stress (A-CWS), specifically focused on Black youth. Culturally relevant content was predominantly absent or contained brief descriptions. The most frequently included content was provider cultural competency training.

CONCLUSION

The lack of representation of Black youth in treatment studies and sparse literature on culturally responsive treatments for Black youth and their families continue to stall significant advancements to disrupt current suicide trends disproportionately impacting Black youth. This study identified several opportunities for implementing cultural adaptations of suicide interventions among Black youth.

DIVERSITY & INCLUSION STATEMENT

One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. We actively worked to promote sex and gender balance in our author group. One or more of the authors of this paper self-identifies as living with a disability. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.

Impact of Dialectical Behavioral Therapy on Anxiety Levels Among African American Adolescents

Anxiety and depression among adolescents in the United States has steadily increased. In addition, significant disparities in access to mental health care exist for African Americans. The purpose of the current project was to support the mental health of African American adolescents involved in faith-based youth groups through implementation of dialectical behavioral therapy (DBT). The community partner was an African American church in Southwest Georgia. Mindfulness training modules are offered in monthly sessions. Pre- and post-intervention surveys and the Generalized Anxiety Disorder-7 (GAD-7) were analyzed, comparing mean GAD-7 scores before and after participation. Nurse-led quality improvement initiatives support adolescent mental health and provide sustainable resources for mental health in rural areas. Results of the quality improvement project reveal improvement in self-reported anxiety symptoms among participants after the 4-month DBT intervention. [Journal of Psychosocial Nursing and Mental Health Services, 62(8), 7-10.].