Meta-analysis: Are Psychotherapies Less Effective for Black Youth in Communities With Higher Levels of Anti-Black Racism?

Meta-analysis: Are Psychotherapies Less Effective for Black Youth in Communities With Higher Levels of Anti-Black Racism?

Forfattere
Price, M. A. Weisz, J. R. McKetta, S. Hollinsaid, N. L. Lattanner, M. R. Reid, A. E. Hatzenbuehler, M. L.
Årstall
2021
Tidsskrift
Journal of the American Academy of Child & Adolescent Psychiatry
Volum
04
Sider
04
OBJECTIVE: We examined whether anti-Black cultural racism moderates the efficacy of psychotherapy interventions among youth. METHOD: We analyzed a subset of studies from a previous meta-analysis of five decades of youth psychotherapy randomized controlled trials. Studies were published in English between 1963 and 2017 and identified through a systematic search. The 194 studies (N = 14,081; ages 2-19) across 34 states comprised 2,678 effect sizes (ESs) measuring mental health problems (e.g., depression) targeted by interventions. Anti-Black cultural racism was operationalized using a composite index of 31 items measuring explicit racial attitudes (obtained from publicly available sources; e.g., General Social Survey), aggregated to the state level and linked to the meta-analytic database. Analyses were conducted with samples of majority (i.e., >=50%) Black (n = 36 studies) and majority-White (n = 158 studies) youth. RESULTS: Two-level random effects meta-regression analyses indicated that higher anti-Black cultural racism was associated with lower ESs for studies with majority-Black youth (beta = -0.2, 95% CI: -0.35, -0.04, p = .02) but was unrelated to ESs for studies with majority-White youth (beta = 0.0004, 95% CI: -0.03, 0.03, p = .98), controlling for relevant area-level covariates. In studies with majority-Black youth, mean ESs were significantly lower in states with the highest anti-Black cultural racism (>1 SD above the mean; g = 0.19) compared to states with the lowest racism (<1 SD below the mean; g = 0.60). CONCLUSION: Psychotherapy randomized controlled trials with samples comprised of majority-Black youth were significantly less effective in states with higher (vs. lower) levels of anti-Black cultural racism, suggesting that anti-Black cultural racism may be one contextual moderator of treatment effect heterogeneity.

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Tiltaksnivå

Behandling og hjelpetiltak

Tema

Utenforskap/marginalisering

Etniske minoriteter

Tiltak

Psykologiske behandlingsmetoder

Psykodynamisk/interpersonlig terapi

Aldersgruppe

Sped- og småbarn (0-2 år)

Barn i førskolealder (3-5 år)

Barn i skolealder (6-12 år)

Ungdom (13-18 år)

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