Progress Notes



Society of Pediatric Psychology Narratives on Racial Trauma and Justice

By Meghan Walls, Psy.D., Electronic Communications Editor
and Idia Thurston, Ph.D., Member at Large, Student/Trainee Development

The Society of Pediatric Psychology’s mission is to actively promote the health and psychological well-being of all children, youth and families. We reaffirm our commitment to all children, youth, and families through addressing injustice, especially racial injustice and racial trauma that are unevenly impacting black communities at this time. We thank you for responding to our call for narratives related to the killing of George Floyd, nationwide protests, and ongoing racial disparities impacting black, brown, and indigenous people. Below are a number of submissions selected to publish. We couldn’t include all of them but want to thank each of you for contributing. We not only appreciate your willingness to be vulnerable and open, but the thoughts about how we can continue to take action to make a difference in pediatric health disparities and justice for all. We hear you and are so grateful for you and for this society.


Where We Should Go from Here: A Brief Commentary on the Role of Pediatric Psychology in Changing Racial Inequality

Recent events have brought attention to racial inequalities pervasive in American Society1-2. We must acknowledge that our own Society of Pediatric Psychology is no exception. Despite increased awareness of public health disparities, access to psychological services remains a privilege for children and families of color3, particularly among black communities4-5. Limited access to psychological treatment perpetuates historical trauma and psychological suffering for Black youth6 and may contribute to feelings of helplessness and despair. Systemic racism prevents black communities from securing basic physiological and safety needs, making psychological and self-fulfillment needs unattainable for many individuals living under such conditions of oppression and discrimination7. While our scientific knowledge about racial disparities continues to grow, we have stopped short of taking action to change the policies purposefully maintaining these cycles of injustice. As a professional society of scientists and practitioners whose mission is “to actively promote the health and psychological well-being of all children, youth and families,” we must do more to promote equality in access to services, racial/ethnic representation in our field, and social policy. Together, these actions can foster a more just and egalitarian society for the most vulnerable youth and families we serve.

Author: Siddika S. Mulchan, Psy.D. Connecticut Children’s, University of Connecticut School of Medicine, Farmington, Conn.

References

Dumont, D. M., Allen, S. A., Brockmann, B. W., Alexander, N. E., & Rich, J. D. (2013). Incarceration, community health, and racial disparities. Journal of Health Care for the Poor and Underserved, 24(1), 78-88.

Slopen, N., Shonkoff, J. P., Albert, M. A., Yoshikawa, H., Jacobs, A., Stoltz, R., & Williams, D. R. (2016). Racial disparities in child adversity in the US: Interactions with family immigration history and income. American Journal of Preventive Medicine, 50(1), 47-56.

Sanders-Phillips, K., Settles-Reaves, B., Walker, D., & Brownlow, J. (2009). Social inequality and racial discrimination: Risk factors for health disparities in children of color. Pediatrics, 124(Supplement 3), S176-S186.

Alegria, M., Vallas, M., & Pumariega, A. J. (2010). Racial and ethnic disparities in pediatric mental health. Child and Adolescent Psychiatric Clinics19(4), 759-774.

Hodgkinson, S., Godoy, L., Beers, L. S., & Lewin, A. (2017). Improving mental health access for low-income children and families in the primary care setting. Pediatrics, 139(1), e20151175.

Danzer, G., Rieger, S. M., Schubmehl, S., & Cort, D. (2016). White psychologists and African Americans’ historical trauma: Implications for practice. Journal of Aggression, Maltreatment & Trauma, 25(4), 351-370.

Perrin, P. B. (2013). Humanistic psychology’s social justice philosophy: Systemically treating the psychosocial and health effects of racism. Journal of Humanistic Psychology, 53(1), 52-69.

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Full disclosure, I am brown.

The dialogue around racial injustice has caused me to reflect on my own experiences and how they are a fraction of what Black individuals entering white spaces experience. Although overdue, I am glad we are openly discussing racism and dismantling systems of power, privilege, and oppression. It starts with conversation, and one conversation that needs to change is how we discuss “diverse candidates” in our spaces. The focus is on recruiting diverse trainees, staff and faculty with rarely a discussion about the environment we are recruiting them into. Our identities are sometimes treated like a checkbox without needed reflection on how the environment actually cares for and cultivates those same identities. For BIPOC, our skin color does not solely have value when it confers benefit to a majority system. We need to challenge assumptions of safety in our spaces, disrupt those that implicitly privilege whiteness, and collectively act to elevate and empower BIPOC identities and voices. “Nothing about us, without us,” to catalyze real change programs, departments, institutions, etc… must center BIPOC voices, especially Black voices, in their commitments to structural transformation towards equity and social justice and actively promote their worth beyond the checkbox.

Author: Marilyn Sampilo,Ph.D., MPH, Center for Pediatric Behavioral Health, North Olmsted Center for Behavioral Health, North Olmsted Community Pediatrics

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The smeared canvas.

It is a challenge to unburden my mind from engulfing itself into the vortex of racial trauma. Over the last month, I have actively attempted to revive my well-being through self care and vulnerability. 

With depletion at its finest and hopelessness at its peak, race-based traumatic stress has weighed down my heartstrings. Their feeble state has encouraged an alarming sense of awareness and concern for future generations to come. By consciously and unconsciously investing my emotional energy in violent media coverage and social injustice, my vibrant self portrait seems to be replaced with dark watercolors resulting in a smeared canvas. The smeared canvas is an overwhelming collection of gloom, exhaustion, and a desperate yearn for reform. Mental health should be on the frontline for the affected and non-affected populations in this country. Our mental health depends on a shifted narrative that can only be crafted by artists who are catalysts for change. It is our responsibility to address and clean our smeared canvases together by acting as pillars of respect, support and community for one another. We must use our voice and treat unity as a powerful force that can repel negativity and repair our emotional damage one brush stroke at a time.

Author: Lauren Chapma,n Texas A&M

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Let's take a mirror to SPP.

As a Black woman pediatric psychologist, the hardest thing about the current times is the repeated exposure to racial trauma. The recent spotlight on disparities in COVID19 deaths and police killings of unarmed black folx have laid bare injustices that have always existed. Articles documenting health disparities often emphasize poor health outcomes among Black, Indigenous, People of Color (BIPOC), yet there is limited acknowledgment of our resilience and ways to reduce risk. When solutions are considered, it is laid at the feet of BIPOC to resolve. Now is the time to change this practice by taking specific anti-racist actions. Before we look to reforming policing practices (and we should), let us take a mirror to our organization and ask hard questions. What percentage of authors, reviewers, editorial board members of our journals and handbook are BIPOC? How well-represented are BIPOC participants in our research? How often are experiences of BIPOC patients/participants interpreted from culture-centric models? How often do we cite BIPOC authors or train BIPOC students? How is racism operating in our organization/institution? Whose voices are not represented? We don’t need to look far to determine next steps–statements of solidarity must be backed by action within our own spheres of influence.

Author: Idia Thurston, Ph.D., Associate Professor, Texas A&M University

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 I vow to be better.

I grew up as a second-generation Asian immigrant. I’ve spent the majority of my life in silence, believing neutrality was superior and priding myself on my ability to try to understand from all sides. But I do know there is a definite, clear line between justice and injustice. My silence on racial injustice up until recent months have been a disservice to my friends, my colleagues, my classmates, and my community. I feel privileged for being able to turn my screen off when recounts of social injustice become too emotionally overwhelming. However, these are everyday lived experiences of Black communities—there is no reprieve. I refuse to be part of a system that accepts that minority groups, especially Black youth, have been systemically oppressed. There are societal systems (e.g., education, healthcare) with mechanisms I can actively advocate for and change for future youth. Hatred and violence are cultivated and can take many forms. Equality and justice are ideals that can be cultivated just as strongly as hatred and violence have been. How will anyone hear my voice if I don’t speak up? I vow to be better. I vow to educate myself and others. I vow to speak up.

Author: Viena Cao, Research Coordinator II, Resilience and Diabetes Behavioral Research Lab, Baylor College of Medicine

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Ahmaud Arbery. Breonna Taylor. George Floyd.

These are just a few of the murders of Black Americans, reaching mainstream media through recordings provided by private citizens.  Sadly, we know that most acts of racial violence are not televised, and I, like many Black and Brown people, am exhausted by the weight of this reality.  The American Psychological Association suggested that we are facing a new, racism pandemic, but this has been the experience of Black Americans for 400 years!  Over the past week, I observed my colleagues’ silence about this “racism pandemic” and its impact on the overall physical and mental health of minorities.  I decided later, rather than harbor negative thoughts and feelings, to facilitate process groups to increase my awareness and understanding of their decision to remain silent. What I learned was important. My White American colleagues expressed that their silence was not complicity but emotional distress—fear of saying the wrong thing, shame and guilt about racial violence against Black Americans, and shame and guilt because of their privilege.  Subconsciously, I knew that those were potential causes for their silence, but their explicit acknowledgement allowed for empathy—not excuses—when having such needed dialogue about race.   

Author: Naadira C. Upshaw, Psy.D., Pediatric Psychologist, Aflac Cancer and Blood Disorders Center, and Assistant Professor, Department of Pediatrics, Emory University School of Medicine

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This is about me, too.

I am largely unaffected by the murder of George Floyd and the insidious genocide which encompasses his death. I am white, able-bodied, and upper SES. May 25 was not much different for me than May 24. No one asked me, “Did you hear what happened?” When I read the call for narratives related to the impact of Racial Trauma, I thought, “This isn’t about me.”

As a health service psychology trainee, I can speak DBT and CBT, and advocate for self-care and deep breathing. How will these help in a racism pandemic? Why is it that I have no APA training for treating racism within myself? Where is the training to reveal the dialectical conflicts of privilege and oppression within me that I can ignore every day? Where, in my progress note, do I describe the effect of the inherent obscurity of privilege on my understanding of Racial Trauma? What colleague who shares my protection from the impacts of these events and my complicit participation in a racialized social system wants to talk about this with me? It is easy for me to stay silent. But my belief, “This isn’t about me,” is exactly why this is about me, too.

Author: Lindsay Olson, Doctoral Student in Clinical Psychology, Antioch University Seattle

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It is my duty to listen, understand, and be an ally.

As a minority in this role, I find myself in a challenging situation. At the height of coronavirus, I wondered if my credibility and approachability as a professional would be affected by the stigma against the Asian community, aware that a mask can only hide so much of my identity. But, with recent events, I am reminded that while all minorities face racial injustice in one way or another, not all racism is the same-that I acknowledge I do not and cannot possibly understand what the Black and Brown communities experience. However, I do understand that while a virus can be contained by having people stay home, washing their hands, and wearing gloves and masks, racial injustice does not operate the same way. It has been too deeply rooted in our history. If anything, we must do the opposite to create change. We must come out and have an open dialogue with our own communities, families, neighbors, and profession, as well as those who are different than us in all the ways possible. Racism is a systemic issue that is also a “social determinant of health.” For me, health means one’s emotional, physical, and mental well-being. Therefore, as someone in this field, but even more so as a human being, it is my duty to listen, understand, and be an ally.

Author: Christine Pho, Predoctoral Intern, University of South Florida

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I want to speak out and to educate.

I should first disclose that I am neither Black, Brown, Indigenous, nor a Person of Color (acronym BBIPoC), nor am I a pediatric psychologist. I am a white, cisgender-passing, AFAB (assigned female at birth), nonbinary person and a quantitative psychology Ph.D. student. My intersection with pediatric psychology is largely as a collaborator. However, while I am white, I see what is happening in the BBIPoC community in America. As a Transgender-identified person, I see what is happening to BBIPoC LGBTQ+ folks of all races and identities. The intersection of racial identity and sexual and gender minority identity regarding recent injustices needs to be addressed by psychologists. The BBIPoC LGBTQ+ community is always hurt the hardest and spoken about the least. I don’t think that Tony McDade, Nina Pop, Iyanna Dior, and Layleen Polanco’s names (Trans people, who I know of, who have experienced violence since the start of the protests) are deliberately forgotten in the psychology community, nor are they deliberately forgotten about by well-intentioned allies. But they are forgotten. I want to speak out and to educate within the psychology community, pediatric and otherwise, for my BBIPOC LGBTQ+ family, especially as a future psychologist myself. Please join.

Author: Rachel Ankney, Experimental Psychology Doctoral Student, The University of Memphis

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What is my role?

As a white ally, I feel it is my responsibility to address racist comments, have difficult discussions related to race, and have a zero-tolerance policy for marginalization and discrimination in my personal life. In my professional life, I do not have as much clarity on my role as a white ally, specifically within the therapeutic relationship. I question what the best practices are in addressing (or not addressing) racist thoughts, feelings, comments, and/or actions in session. If I do address this in session, what impact will it have on the therapeutic relationship? Within the context of therapy and treatment goals, is this my role? What even is the best way to go about addressing these thoughts, comments, etc.? Also, what is my role in other professional relationships, such as within my interactions with colleagues, supervisors, and other staff members? With everything going on in the world, I have developed an understanding that there is much to be learned and this is sure to be a lifelong, ongoing learning process. While I have gained clarity and solidified my goals as an ally in my personal life, I have become more confused and concerned about my role in my professional life.

Author: Morgan Bolen Predoctoral Intern, University of South Florida