DOI
https://doi.org/10.25772/40E1-AR72
Author ORCID Identifier
https://orcid.org/0000-0001-6835-9608
Defense Date
2023
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Psychology
First Advisor
Heather A. Jones, PhD
Second Advisor
Rosalie Corona, PhD
Third Advisor
Nicole Corley, PhD
Fourth Advisor
Shawn C.T. Jones, PhD
Fifth Advisor
Stephanie Crewe, MD
Abstract
Racism within the institution of health care can manifest as discrepancy in access to and quality of care, prejudices and biases held by health care providers, and Eurocentric interventions that often fail to address cultural strengths, experiences, and values of Black and other minoritized children and their families. Black children experience significant disparities in mental health symptom presentation and severity, incidence of comorbidities with other behavioral health disorders, and access to quality behavioral health services. Given existing health disparities in service utilization, Black children are increasingly receiving their behavioral health treatment in pediatric integrated primary care (IPC), which has potential to reduce mental health stigma and improve Black children and their families’ engagement in behavioral health treatment. Despite this, limited studies have focused on treatment engagement with Black children and their caregivers beyond treatment attendance. To fill this gap, the current qualitative descriptive study used Critical Race Theory, and a conceptual treatment engagement framework, to understand how institutional policies and structures, as well as predominant cultural norms, worked to impact the mental health care decisions and behaviors among Black caregivers. Using reflexive thematic analysis, Black caregivers’ (N = 8) demonstrated a dissatisfaction with IPC behavioral health services grounded in perceived racial bias and discrimination, either at an individual, cultural, and/or an institutional level. Three themes emerged from caregivers: 1) longing/desiring intentionality, 2) longing for connection, and 3) longing for culturally empowering treatment. Caregiver’s perspectives aligned with the tenets of critical race theory. Research and clinical implications are discussed, and solutions are provided to center the Black experience in therapy and care in IPC.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
12-15-2023