Good afternoon, everyone. I'm LaVaughn Robinson, and I want to thank you all for coming today. And I also want to thank the American Psychiatric Association, the Morehouse School of Medicine, and Dr. Vinson and her colleagues for inviting me to have this opportunity to talk to you today about a very pressing health concern for African American adolescents, and that is suicide. Suicide, I don't know that you know, but it's the third leading cause of death for African Americans between the ages of 15 and 19 years. Now, I think this talk that we're having today and conversation we're having today is particularly important because while it's the leading cause of death, it is also preventable. And in other words, these cause, these deaths don't have to happen. They can be prevented. And I think what we, well, at least one of my goals today is that we will have a conversation and talk about some things that for all of us who work with teens can have an eye toward prevention. And that it is a serious and dire health consequence, but it's a health consequence that if we are attuned to, that hopefully we can mitigate and reduce, and that will be the goal. So now of concern, you know, even though, you know, suicide, even one suicide is troublesome and you don't want that, but the rate is increasing for African American teens in recent years. And between the years of 2018 and 2022, the rate for African American adolescents rose 33%, while at the same time, the rate for white teens decreased by 11.5%. So, you know, clearly there is something I think we should consider relative to ethnicity and race around this problem, some pattern of behavior events. Of concern also is the fact that I am of the opinion that the numbers while startling and alarming are underestimates. And I think they're underestimates because of misclassifications of deaths. In other words, related maybe to cultural mores and other factors, African Americans may be dying, you know, and babies dying by suicide, but the cause of death may be attributable to other factors. Now, the question is why are African American youth so vulnerable? You know, what being African American that is distinctive that would produce this vulnerability? And most importantly, how can this vulnerability be mitigated? Advance, please. In a recent study, you know, very, very recent, and other studies in the past, the few that are available have also suggested that African American teens who commit suicide don't necessarily carry a mental health diagnosis. In fact, in this study, 67.7% of those with the documented suicide had no prior mental health diagnoses. So, when we think about suicide, traditionally, we think about things like particularly depression being related to suicide, possibly anxiety, psychiatric kinds of, you know, mental health problems, etc. And other kinds of mental health problems. But what we're seeing by the studies is not necessarily for African American teens. So, what then is distinctive? Well, racism is distinctive. Exposure to community violence is distinctive. And concentrated economic and social disadvantage are distinctive factors that might be predictive and relevant in trying to understand suicidality in African American teens. Advance, please. So, if then it is true that traditional factors like depression, anxiety, and so on are not necessarily indicators or predictors of suicide for African American teens, the more traditional indicators, then that would suggest that conventional mitigation strategies too may be of limited effectiveness. In other words, the treat the child for depression may not be the most effective way to go about preventing or reducing the suicidality. I think what we are looking for or need are evidence-based preventive interventions for African American adolescents that do consider distinctive risk trajectories of these youth. Advance, please. So, one reason I think we have underestimates and we don't really understand the full severity of the problem, you know, as I indicated before, related to the cultural mores, African American teens may engage in behaviors that don't necessarily seem suicidal, but at the end of the day, it was a suicide. In other words, they're no longer with us. We have in the literature, and if you sort of observe and, you know, the behavior of African American teens, sometimes you can advance. Sometimes there's this phenomenon called victim-precipitated homicide or suicide by cop, wherein the teen puts him or herself in harm's way. Advance. So, that way, you know, the end result would be loss of life, but it doesn't seem as if it were a suicide, per se. It was the result of some sort of commotion wherein, you know, there was gun violence or other kind of violence that, at the end of the day, there was a child who was lost, and the cause of death then may be registered as something other than suicide, but the question becomes, why was the child so willing to put themselves in harm's way? Advance, please. I would argue, and some of the literature suggests, and, in fact, some of my own data that is not yet published suggests, that there is a very strong relationship between interpersonal aggression and suicide. Strong relationship between interpersonal aggression and suicide. With that being the case, then, in terms of doing a risk assessment, in addition to other kinds of societal variables that are of interest, you know, like poverty, you know, exposure to community violence, which is linked to suicide in the literature, when we see children who are particularly aggressive, I think it would behoove us to not simply understand these children as aggressive children, but also beg the question, does this child need a risk assessment for suicide? In other words, it might be prudent for those who were working with African-American youth that when they present to us with, you know, relatively notable aggressive tendencies, that we, as a cautionary procedure, go ahead and do a suicide risk assessment. Advance. Now, most kids, even though the numbers are startling and horrible and very alarming, most African-American kids don't commit suicide. Now, that's the good news. So, what we, as professionals, need to ask ourselves, then, what is it, you know, within those who don't, they're also African-American, they probably, maybe, are also poor, they may also have a lot of exposure to community violence, but there's something protective operating somewhere, and can we identify those strengths that are operating, and can we, you know, utilize those strengths as we try to intervene in a preventive mode with African-American children? So, you know, what might be the individual-level strengths, what might be family strengths, what might be community-level strengths? Please advance. So, in that mode, then, you might say, then, well, maybe, because being African-American is a high-risk factor for being discriminated against in our society, and we know that there's research that links racial discrimination to suicidal ideation, and we know that suicidal ideation is linked to suicide attempts and completions, then, you know, maybe that might be a starting point in saying, well, maybe some sort of universal interventions might be warranted for African-American children to help them cope with societal stress. So, in understanding suicide, it might be well to understand that suicide can be considered a coping strategy, albeit inappropriate, albeit devastating, albeit irreversible. When the individual is asked to or has to cope with what they believe to be insurmountable emotional distress, and they don't feel they have options, suicide becomes a coping strategy, it becomes an option, it becomes an option to relieve the emotional distress. Now, most good interventions, and in the case of suicide prevention as well, the literature suggests that interventions who, or that are grounded in theory, have an advantage in terms of being effective. Now, one of the more prominent theories today is Joyner's interpersonal theory of suicide, and it has a lot of empirical support, and it's a very complicated, complex theory, but the main premise of his theory is that individuals who have feelings of thwarted belongingness and perceived burdensomeness are predisposed to hopelessness, and they're more at risk for suicidal ideation. Okay? Advance, please. So, there's no point of throwing the baby out with the bathwater. There is a lot of empirical support for Joyner, and we concur in my team that his premise and his theory, and it is, you know, documented in literature, certainly has value, but we also suggest that in the case of the African-American adolescent, there might be and should be some level of reformulation of that theory to be more inclusive of more societal contextual factors in addition to the individual level factors. In other words, thwarted belongingness, perceived burdensomeness, hopelessness, suicidal, those are all at the individual level. Okay? So, it's saying that to work with a suicidal individual or prevent suicide, we need to deal with these individual level factors, and they are important, not to negate that, but for the African-American child, I am suggesting there are other factors that also need to be attended to in terms of predicting risk as well as mitigating risk, and as I said before, those would be factors like systemic racism, poverty, exposure to violence, and the perception, real or imagined, of being discriminated against. Advance, please. So, in our reformulation of, you know, the pathway to suicidal ideation, active suicidal ideation, and again, that's important if you're doing prevention work because you don't want the suicide to happen. You're looking for predictors, and where can you interrupt the path? Interrupt the path. So, ideation is linked to attempts which are linked to completions. So, we want to interrupt that path, and we suggest that the path starts before what Joanna would suggest, where he's suggesting the pathway starts at belongingness, thwarted belongingness, and perceived burdensomeness. We're saying the path starts at poverty, violence exposure, and discrimination for African-American children. And we're saying that there are ways to mitigate that potential along the way, or moderate that risk, through things that are probably operating in the community and with children, such as racial socialization, racial identity, traditional coping, and race-specific coping. We'll talk about that in a moment. Now, that's one point at which the path can be interrupted, and I think it does happen for some youth because, as I said before, we know that most African-American youth are not suicidal, or don't take their lives, or don't put themselves in harm's way, but far too many do. So, if the path is not interrupted, then the pathway could progress to what Joanna would think about as thwarted belongingness, and we expand upon that to say, in the sense of societal exclusion, in particular for the African-American child. In other words, it's not just, you know, not belonging, but it's because you were Black in America, you were marginalized, and the opportunities to be accepted and received were limited simply because of what you looked like and your background. And in terms of perceived burdensomeness, not just that you are perceived that you're a burden, but that burdensomeness that you perceive has to do with society's role in blaming you for societal ills. In other words, society has a tendency sometimes, and we see it all around us today, when people look a certain way and then there are problems operating in the world, it was because of those people who looked that way. It was because of those people who took our jobs. It was because of those people who did it X, Y, Z. So, the African-American child has the burden on them, an extra burden, simply because of how they look, potentially, of being marginalized, being blamed for things way beyond their control, and this is a challenge for them to cope with. Now, there's another opportunity, you know, when the child feels distressed related to some of these things, again, for that to be interrupted, you know, using more strength-based strategies like racial identity promotion or racial socialization and race-specific coping. If that path is not interrupted, then the child progresses on to what Joanna would talk about as hopelessness, but we talk about it as futility, meaning it's more than hopelessness in the traditional sense. It's a sense of futility, a sense of futility that regardless of what I do, not much will change, and there's not much that I can do personally because of the society that I'm living in. I can't change society, and then if all those paths are not interrupted, the child could progress to active suicidal ideation. Advance, please. So, there are some studies in the literature that have shown promise in reducing suicidal ideation. The problem is that for the African-American child, the studies don't necessarily include samples of African-American children, or if they do, very sparse, and so you can't get any kind of sense of, you know, how relevant the intervention was by race. Also, often the interventions do not attend to some of the things we're talking about now that are distinct risk factors for suicide, like racial discrimination, community violence, exposure, and so on. Those factors are not part of the intervention, and they don't include distinct adaptive coping skills that would be more relevant for African-American children, maybe different than other children. Advance, please. So, we know that, and myself and others have said, well, we need to do something about it. There needs to be something done about that, you know, because it is a preventable phenomenon, so we just need to understand what we need to do in order to mitigate this problem. So, in that vein, some years ago, I started working on a preventive intervention, the adaptive coping with stress course. Advance, please. So, this intervention is an adaptive intervention. You know, you hear a lot of talk about intervention adaptations. I chose to do an intervention adaptation for speed reasons, actually, to be quick about it. When the problem became so significant in my mind, I have, in the course of my career, developed interventions from ground up, but they take longer to develop, you know, going through the whole process of intervention development, and I was aware of the work of Gregory Clark and his colleagues with their very empirically validated coping with stress course, but there were problems with that intervention. It wasn't culturally grounded, although it was empirically validated, and it was cognitive behavioral, and we know that cognitive behavioral strategies are very important in the prevention of suicide that they tend to work. It was validated on teens out of Oregon who were middle class, and for the most part, who were experiencing difficulties as related to some issues with their parents. In other words, there was a genetic factor, and what I'm suggesting here, while I'm not obviating the fact that African Americans could not, you know, could not be a genetic link, it could be, but I don't know that that is the problem in the main. In the main, I think why you see these exorbitant rates has to do with more societal factors, so even though there were many advantages of Clark's model, and I wanted to use certain aspects of it, I also understood certain limitations of his model, so then I went about a process of doing an adaptation with one of my earlier grants, and since that time, I've done what I call a modernization of it. There have been two iterations of the adaptation from Clark's work. Now, when I do an adaptation, one thing I think is important and why the intervention does work, is I don't as a clinician decide, well, I think these are key components and this is what I'm going to include in intervention. Even though I am African-American, I am familiar from lived experiences with some of the things that are germane to these children, I actually go out and ask the children. I spend a whole year when I go through the adaptation process and the modernization process. I spend a whole year doing focus groups with children that I call key informants. Usually, my intervention has to date and delivered in schools. Usually, I will take a sample of youth from at least two or more schools, and work with them through the course of the year. The first time we did it, we went through Clark's curriculum, a dry run, and we asked the children to give us input in terms of how relevant they thought that intervention was, would they want something like that? But also, where did they see that that intervention might be limiting relative to their own experiences? They pretty unanimously agreed that they needed something like that. But they also were quick to point out some of the differences in that intervention relative to the experiences that they have, which is what I suspected. Then we went through a process of, okay, where do we need to make changes that will be relevant for you? The intervention is based on Clark's model, uses much of his same ideology relative to cognitive behavior therapy and coping with stress, but it also has several adaptations. To do the adaptation, I followed a framework suggested by another colleague, Bernal, out of University of Puerto Rico at the time, who had done cultural adaptations for kids who were Puerto Rican, and my children African-American, but I felt his conceptual frame was appropriate. In other words, when we looked at Clark's model, the language needed to change. There are certain language styles, even if just the name of the folk in the scenario that are more relevant for African-American that they can relate to versus some other names. For example, my name is Lavone. That may give you a hint, if you never saw me, that I might be African-American. There are other names that are more in keeping with what African-American parents named their children. We set about naming the folk in our scenarios using common believed to be African-American names as suggested by the children. They gave us the names, I didn't make them out. The notion of persons. I don't feel in my studies, we've been very effective. We've got a lot of good data suggesting that intervention works, but we've not said that you need to be an African-American or black to deliver the intervention. What we have said is that you must have knowledge of and understanding of and some experience working with African-American youth. That being said, our facilitators have been from every ethnic background, probably conceivable, every gender. That's not been a consideration, but what has been a consideration is their preparedness to work with African-American children. Then metaphors. We use a lot of examples, but if you were to go back and look at Clark's examples, his examples are more suited to, I think, white middle-class children. We use metaphors and examples and visuals, and again, that our children can relate to. We brought in a very skilled African-American artist who was very well-trained, and the children would tell me things, and then I would talk to the artist as Nina. This is what the children are saying, and then she would make visuals. Then I would go back to the children and I said, well, is this what you were trying to say? We will go back and forth several iterations of the whole thing until finally, we would have visuals that the children said was captured what they were trying to say and would represent what they experienced in their community. The content, as we talked about, race-specific coping and the kinds of scenarios that they were problem-solve around were quite different than the problem-solving stressors that Clark's children would need to problem-solve. His children didn't have exposure to community violence. They were not poor. They didn't have those kinds of stressors. Our children had these stressors. We needed to talk about and include content around stressors to figure out how to manage that were relevant to them. Concepts, values, though the intervention had to also think about if you're trying to have people adapt and acquire skills, those skills need to be commensurate with the values of the community and of the culture. That had to be considered as well as the goals, what will be culturally appropriate goals. The methods, we did a lot of training. The intervention, you'll see a few snippets of it. It's very user-friendly, but I didn't throw it at the facilitators and say, go use this, I think it'll be fine. We would meet weekly, have extensive training sessions until I felt they were at criterion. Then of course, we would go back and do fidelity checks to make sure they stayed at criterion. There was a lot of attention to the training and the fidelity of delivery. Important about this intervention, different than some others, the context of the child. This intervention acknowledged that these children lived in different kinds of environments and contexts relative to others, and that was part of what we talked about and included in an intervention. This is a snippet. When I started to develop the intervention, my hope was, and my hope remains, that at some point with enough data to support that it was an evidence-based intervention, it will be widely disseminated relative to where it is now. Right now, it's mainly within the Chicago area. But I wanted it easy to utilize, even though there is a training component, that it wouldn't be burdensome to train, and folk could easily train and learn how to use the intervention. It has a lot of icons, a lot of notes to facilitators in terms of when it's time for them to say something, the things that we recommend that they say. We give them hypothetical examples to help them probe and get the children to talk about certain things. In addition to all the language, we have the icons to go with it so that the clinician can easily figure out what I need to do next. So it's hopefully user-friendly. Now, this is another major deviation from Clark, because Clark's children, as I said, came to him mainly because of genetic predisposition. As I said to you before, our children tend to be fairly aggressive, and there's that relatedness between aggression and suicide. So I added a component that Clark did not include in his coping with stress program, and that is the component on a session about aggression. So it's a 15-session model, and I can, at some point, maybe talk to you about what the different sessions are. But this is an added session, different than what Clark has, where we talk about, in addition to what stress is and what stress looks like, and how to recognize when we're stressed, we also talk about what aggression looks like, and how to recognize when we're being aggressive, and how to think about ways of expressing ourselves, calming ourselves that are adaptive versus aggressive, which can be detrimental. Advance, please. This is a visual created by the artist in collaboration with the children. Now, this visual I include because this comes from one of my earlier publications. But the publication, as you know, as publications go, it was out there for a while before it actually was published. But I've actually done one adaptation here with this visual, and that is where the young girl is thinking to herself, how to problem-solve about seeing her brother be arrested. Now, this is an image, again, that the children told us was very burdensome to them, very stressful to them, very commonplace to them of cop brutality. For little or no reason, being accosted by cops, being brutalized by cops, being thrown on the ground by cops. Then you see the gun. They wanted us to know that there was always this inherent concern, what's going to happen to me? Then you see the young lady, the little girl, she sees it. She's on the street with her brother. She sees this happen to him. What the children who we did the modernization at that time told us, well, because we talked to them about alternative thinking, not necessarily negative thinking, but trying to make the best of bad situations so that they're not overwhelmed by the situation. They suggested that the little girl might be saying something like, I hate to see him get arrested, but he'll be better in jail. Well, that's an old think tank. It used to be that we did think maybe when there's an incident on the street or so, if you take the children away from the incident, maybe take them to the jail for a minute, cool them out, call the parents. But that's no longer the case given what happened with George Floyd. I think people are terrified to go to jail or be in the custody of cops. So now I leave that bubble blank and I've whited it out. And when we're in session, we allow the children to think about ways that's not overwhelming. Should this scenario, they witnessed this scenario, what can they think about or say to themselves so that they're not overwhelmed by it? And there's also with our children, we have to be cognizant that we're not blue sky, that we validate their reality, that we don't minimize their reality. So we have, and it's very difficult. We have to think about ways of problem-solving, rethinking, reframing that's healthy to keep the anxiety down, to keep the stress down, but at the same time linked to the reality of the world that they live in. Advance, please. This is another one of the snippets from the intervention. This is a very common experience. The children gave me this one, but frankly, I've lived this experience myself, going shopping as a team, being followed around in the store. And my friends and I, we would sort of laugh. We would sort of say the things we said to ourselves, I think, to make ourselves feel better as well while they're following us. Those other kids, the white kids, they're doing all the stealing. We're just here and we've got money and we intend to buy. It's on them. And this young lady is also trying to think, give an alternative thought to what's happening to her, that just because of the way she looks, she's been targeted as a potential thief. And she's being followed around. This is very disrespectful because she always pays. She's never stolen anything from the store. And the way she talks down the stress of it all, is saying, well, at least she hasn't said anything mean to me or done anything. Although it is disconcerting that, you know, she can't shop without being followed and obviously followed. Next slide, please. So, you know, in terms of evaluating the intervention, we, around midpoint, do an evaluation from the children. We ask them for input in terms of whether they feel this intervention has relevance for them. And we, to date, have gotten very good information from them. And they're overwhelmingly saying that they like the program. They feel that it's meeting their needs. They feel that the facilitators are effective and doing a good job. And interestingly enough, we typically meet with them once a week. They say they would like to meet more than once a week. Advance, please. This study was just recently published in JCCP, Journal of Consulting and Clinical Psychology. We're starting to get out some of the data, where we looked at how well children do who have the advantage or exposure to this intervention relative to those who don't. And the standard controls. Now, in our study design, the controls are the standard care condition is the school-based health center, which is staffed with social workers. And, you know, once we do our randomization, some students are randomized to intervention with us, and then some are randomized to the health centers. So relative to standard care, this is what we're seeing with our students, is that they do tend to have better outcomes relative to suicidal ideation, less ideation over time, particularly at the 12-month follow-up. So this is good news. What it's saying is that this intervention does have an impact, and it seems to have a more sustained impact as time goes on. Now, the good question would be, what happens, you know, even more distant, in a more distal future? We only had grant funding to follow the children to the end of their sophomore year, which was the 12-month follow-up. If the trend were to continue, we might see even greater differences between those who were in the intervention condition versus standard care, because that's the way the data seems to be trending, but we don't know. So, yeah, at some point, a longer follow-up, you know, and all this has linked to funding, would be great to know, you know, what happens with more extended time in terms of differences between children who have exposure to the intervention relative to those who don't, not only around suicidal ideation, but other kinds of outcomes that could be associated with suicidality or inability to adaptively cope, like graduating high school or coming in contact with the juvenile justice system, that sort of thing. Advance, please. This is a study where we just started to look at the data, and it's looking a little interesting as well. We're getting a good difference or significant difference at post-test, but between kids in the intervention and those not in the intervention, but the effect seems to dissipate over time. Now, if this finding is correct, what it would argue for are booster sessions, because what it is saying is that the intervention can be effective. It's very effective at post-test, and if we were able to offer boosters, would we not see that same trend in terms of the dramatic difference between those who were exposed to the intervention versus standard care? What it's also saying, if you look at the difference in, say, suicidal ideation, hyperarousal, and hyperarousal is one of the key predictors for African-American children of suicidality, is that some problems need more of a boost or refresher relative to others. The outcome, then, may differ depending on the problem itself, and in the case of hyperarousal, it's suggesting this finding so far is that for something like this, there needs to be some sort of continued attention to the children, maybe booster sessions, which is reasonable. We go into the schools during children's freshman year, and we provide the 15-session model, and that's it. And then we follow them in the fall of the sophomore year, and we follow them in the spring of the sophomore year, but it would seem reasonable to me that, and I'm in the process now of thinking about how to develop booster sessions, that the schools would be able to offer boosters maybe in the sophomore year, in the junior year, you know, to keep whatever learning that they have, or mastery that they have, to keep it active and not dissipate. Advance, please. Okay, so in conclusion, what I want to leave us with is the notion, or the idea, or the being convinced that this very serious problem that's trending in the wrong direction is preventable. And I'd like to ask us to think about innovative ways to think about how we work with African-American children, because they are different. You know, their experiences are different. How we work with them to introduce strategies to prevent the phenomena. And I would also like to suggest that we introduce universal strategies. In other words, because much of what exacerbates the problem for African-American children, most of us will be exposed to. And even though we might not yet be suicidal, we might have other kinds of non-ignorable, you know, oddities that we succumb to, because we are living in a racist society, or a society where we experience a great deal of discrimination. And it's systemic, and it seems to be very ingrained. So would it not be of value then to offer prevention as a universal sort of strategy to children, and not just high schoolers with this intervention? We know that middle school children have alarming rates as well, African-American children. So this intervention is cognitively adapted or suitable for children at the ninth grade and above. I think it would be very, very important to expand upon this intervention and do yet another adaptation that's more of a developmental adaptation that includes not only the cultural factors, but the developmental level of the child. We know from not just my research, but other studies, that there are links between some of these socio-ecological stresses like discrimination, community violence, exposure. We know from studies that, you know, suicide manifests quite differently, that African-American kids are not as prone to overdose. They're not as prone to self-inflicted gun wounds, but they're more prone to these deaths that are accompanied or, you know, surrounded by some sort of violence that's more homicidal. So what can we do around the social ecology to reduce that? And how can we increase more of the strengths that we know are operating in the environment for these children within the culture? Because not, as I said, most are not suicidal. How can we draw upon those strengths and make them more widely available to all children? With that, I think I'll take questions. Thank you. Thank you so much, Dr Robinson. While we wait for our participants to put some questions in the Q&A tab, I have a question for you. So I know you hinted at this once or twice, but I would love to hear about future directions for this research, things that you're working on, publications, and kind of next steps for this fantastic research. Well, we're working on a lot of things. Right now, we have a study that's funded by NIMH that, you know, the model you saw in terms of reformulation of theory, my earlier studies didn't have the data to examine the theory of my reformulated theory. So once we start to think about this and understand it a little better, we have now incorporated measures in this current study that will allow us to actually test some of the things we hypothesized that are predictive of suicide of African American kids. Now it's going to take a while, but I'm very excited to get the data out there. We think, you know, and that will be informing because, again, you can't really mitigate a problem if you don't really understand the basis by which the problem arrived. So a better understanding of what caused the problem should yield a better understanding of how to mitigate the problem and the preventive strategies and the development of preventive interventions that will go possibly beyond the individual. Right now, my intervention is at the individual level, working with children, providing coping strategies. But can I do more? Could others do more that go well beyond the individual level? And I did allude to working with younger children, but very important, and this kind of became very salient to me in COVID. We were just awarded the grant, and we couldn't start for two years. We couldn't start because the school system I work in closed for two years. And of course, children were not doing well. African American, non-African American, COVID hit them hard, and they're still, I think, trying to, you know, adjust. This would have been an opportune time to maybe work with children. Children were doing remote learning, so we knew where they were. The school system could find them, but we didn't have a remote intervention. We didn't have a digital intervention. We didn't have, I mean, the way this intervention works is, you know, it's an in-person group scenario. But I would like to develop and work with colleagues to develop, you know, digital interventions that children could have ready access to. And, you know, part of, for example, this intervention does relaxation training, one of the devices to reduce stress. You know, and other techniques and strategies that children can use and have at their disposal through some of their handheld devices like telephones. So, you know, very much like to do that. And very much would like to see or have the ability to do longer longitudinal follow-up, because what happens in the long run with these children? You know, what happens after sophomore year? What happens in junior, senior, and, you know, even beyond? You know, do they have healthier outcomes across the board? I'd like to be able to examine. So there's a lot I'd like to be able to do. Fantastic. Kind of on that note, actually, and related to the question that I was going to answer next, or ask next, we have a question from an audience member. So the question is, what plan has been in place for research in terms of African American teens and their knowledge gearing to their communities, education about moral values and economic support at home and after school? So kind of that question of, related to my question about policy. So I know, you know, what are you thinking in terms of that plan for research of connecting all of these things that have been mentioned, like knowledge, gearing to communities, moral values and economic support? Well, as you know, it's a worthy aspiration, but it's also challenging because, you know, I suggested that I thought that there might need to be universal interventions. Now, because my study is considered research, parents have to give their permission, children have to give their assent. But if you were to institute something like this school-wide, you know, as part and parcel to the school day, part of the normal operations of the school, and you know, there is a value-laden component here, you know, this notion of what my informants have informed me and what I know from my own lived experience, or, you know, some things that are inherent to African American culture and lifestyle and so on. Would that meet with opposition? You know, so nothing is easy, because this is not a generic intervention. It's a very culturally tailored intervention. I have, most of my schools tend to be mostly African American. I target them for that reason, because it's an intervention that we know, from past studies, work for African American kids. But I have gone into a school where the population was more diverse, and they, you know, the Latin kids, the white kids, they're also having problems. And then there's the pressure on me, well, what do you have for these children? And I have to try to explain, I can't give this intervention to children other than African American, because the limited data I have in terms of the validity of it and empirical, you know, backing of it is for an African American child. It was developed by African Americans for African Americans. And because it's so culturally laden, I might cause harm to try to give the intervention to a child from another culture. And when you have communities that are desperate to provide services for children, you know, what do you do? Absolutely. So, also, a great segue. When we're talking about African American teens in this research that you've been doing, what would you say are key indicators of risk in terms of, you know, this kind of interpersonal aggressive demeanor that you mentioned in earlier? Earlier sides that should signal medical professionals or individuals at school, that sort of thing? Well, we work with school-based health centers, and, you know, we do screening, you know, before we randomize. And when we see snippets, particular snippets of potential suicide risk, we do a referral to the health center, and they do a full-blown risk assessment. Now, all these things are tied to funding. How many social workers or, you know, clinicians are in a school to conduct these risk assessments when, you know, I'm working in schools where, you know, a fight is not an uncommon occurrence? Okay? So, you have these children who are not just maybe saying things that are aggressive, they're actually fighting sometimes. And where's the, you know, where are the resources? Who's going to do all these assessments to, rather than just sort of send them to the office and put them in some sort of disciplinary scenario, detention, this and that, and them being, you know, viewed as an aggressive, inappropriate, out-of-control child? Where's the resource to look at this child a little more to see if there's something going on? So, we have a problem that we don't have adequate resources, probably, to, you know, to work with children when we see heightened aggression. And we pigeonhole them, and we designate them as a behavior problem. Absolutely. We have another comment slash question. So, this individual, Dr. Capoli, I hope I'm pronouncing that right, wrote in and said, I take the train to work, and we'll see adults who are assigned to protect and provide peace and direction with these teens. There's a chartered school close to the train station, but unfortunately, most of these, mostly these teens will be smoking, fighting, will not attend class while class is in session, and these adults are paid to redirect these teens to better awareness for their growing up, but they ignore seeing that scenario. The only time the children will be in school is when the police is in guard at the station. What should be done about this? I agree with you. What we have always known about this intervention is it is school-based. So, and we work in environments where, you know, there's a, you know, a great deal of concern. These schools were targeted for that very reason. But we also know that there are numerous children who are not in school, who have potentially problems more significant than the ones I see in school. And there are no services really for them in a very coordinated, programmatic, consistent way. But an intervention like this could be implemented in the community. There's no reason why it couldn't be. I just happen to work in schools, but the intervention itself lends itself to be implemented in churches, community groups. I mean, multiple, there's no reason why, but the issue would be, how do you get the children to you? How do you entice them to come to you? Would we use media blasts? You know, how would we, and that's why I said, you know, I would like to work with colleagues to do more advanced technological, digital kinds of things where maybe we could have, now, when you talk about suicide, if you do a risk, some sort of screener and a child is seen as being suicidal, that introduces another problem if they're not near at hand. When they're in the school, I can immediately refer to a professional in the school. If we were doing community level interventions and we were asked some of these very poignant questions, which I do ask in my research about suicide risk, then I have the problem of, and what happens next? So I would probably have to tone down the intervention, not ask some of those very germane questions about level of suicide risk, but I could still ask about aggression. I could still talk about coping. All these things that we know that are important and linked, those things could happen, you know, more at large when you don't have to have the ability to do an immediate referral for a risk assessment. Does that make sense? Yeah, so kind of the idea that these teens who are not in the schools where say intervention is being done, looking at a more community oriented intervention. The challenge would be getting the children to you, but there's no reason why it couldn't happen in the community. So when you're thinking about a community kind of taking this intervention that you described that you're doing in schools and thinking about these community groups like churches, what would you say are kind of, what would you think would be the main differences in the intervention process versus what you've described in the presentation? Well, it's a 15 session model, and I'm not convinced that 15 sessions are absolutely essential. I think, you know, because we're talking about reaching children and keeping them engaged and having some outcome of benefit because they engaged in the experience. So I think it would be very important, you know, future research to figure out maybe what are the components of the intervention that are most needed to get some of the outcomes that we're hoping for and to reduce it down to a more manageable number of sessions because 15 sessions would be a good number of sessions to ask children to repeatedly come to. But maybe if we could get them to come to five, six, you know, and still get a reasonable outcome, that might be a goal to strive for. Yep. Fantastic. Okay. Well, we have just about a minute left in our presentation. So I'll just give a couple quick comments about this webinar. So this will be available as an enduring research in our APA Learning Center. You can claim credit for the live version that you've attended today in the APA Learning Center at the conclusion of this webinar. And we will be posting slides as well. And I will just advance very quickly through Dr. Robinson's literature citations, which will be available in the Learning Center that you could review. And we have one last question, Dr. Robinson. Someone asked how they could get involved in this kind of research. That's a pretty... I'm always looking for help. So I'm in the Chicago area, but I'm willing to, you know, talk about working in other areas. You know, I don't know if you're already in the research field, you're already doing work in this area, but we certainly, maybe this would be an offline communication. We certainly are wanting to expand our partnerships. Fantastic. Do you feel comfortable with me putting your email in the chat, or would you like me to hold off on that? Okay. So I will put Dr. Robinson's email in the chat very quickly. So Dr. Robinson's email is in the chat. Thank you to all of our attendees, and thank you so much for a fantastic presentation, Dr. Robinson. Thank you, Hannah, for all the assistance. Thank you very, very much. Of course. Thank you, everyone. Thank you for coming today and for the questions. Thank you. Bye, everyone. Bye-bye. Thank you.

African American adolescents

suicide prevention

mental health

cultural adaptation

cognitive-behavioral therapy

racism

community violence

economic disadvantage

Adaptive Coping with Stress Course