The Therapeutic Role of Ethnic/Racial Identity and Acculturation in a School-based Socioemotional Intervention

Ethnic/racial minority youth are disproportionately impacted by disparities in access to evidence-based mental health interventions compared to non-Hispanic White youth. Stigma, discrimination, acculturative stress, economic constraints, limited access to treatment, lack of insurance coverage, and negative attitudes and beliefs toward mental health services are some of the most significant barriers that prevent many ethnic/racial minorities from receiving adequate mental health care. School-based mental health interventions overcome some of these access barriers for ethnic/racial minority youth. However, it is important to understand the extent to which the effectiveness of interventions is impacted by youths' ethnic/racial identity (ERI; the degree to which an individual explores and commits to their ethnic/racial group), along withacculturation processes. The current investigation explores how ERI and acculturation impact youth psychosocial functioning and how these cultural variables affect treatment outcomes of a school-based socioemotional intervention.Seventy-one children (52.1% male, 98.6% ethnic/racial minority) participated in the Resilience Builder Program℗ʼ (RBP), a school-based resilience intervention for children with socioemotional difficulties. Correlation analyses explored the relationships between ERI and parent-, child-, and teacher-report of baseline functioning across internalizing and externalizing symptoms, social, emotional, attentional, academic, and adaptive functioning. Moderation analyses examined the effect of ERI on RBP treatment outcomes across domains of functioning and informants. An examination of differences in baseline functioning across acculturation-related variables (i.e., comparisons between U.S.- and non-U.S.-born participants; between participants from English-dominant households and those from other-language-dominanthouseholds) was also conducted. Additionally, qualitative analyses examined caregiver perceptions of their child's difficulties.Primary analyses revealed strong associations between ERI and positive outcomes including greater emotional, attentional, and adaptive functioning, stronger academic skills and enablers (e.g., interpersonal skills, classroom engagement, academic motivation, and study skills), and greater resilience. Three-way interaction effects indicated that ERI played a key role in moderating RBP treatment effects across domains of internalizing problems, social, emotional, attentional, and adaptive functioning. Differences were also observed between subscales of ERI (i.e., Exploration and Commitment), such that ERI Commitment demonstrated greater effects on treatment outcomes compared to ERI Exploration. Acculturation-related analyses demonstrated clear patterns in baseline functioning between cultural groups. Non-U.S.-born participants and participants from non-English-dominant households endorsed better baseline functioning across domains. Differences were particularly salient for teacher-report. Acculturation-related analyses provide support for the immigrant paradox, suggesting that first-generation immigrant youth typically demonstrate better functioning compared to U.S.-born ethnic/racial minorities. Results demonstrate how cultural variables, such as ERI and acculturation, relate to baseline functioning and treatment outcomes.This was the first study to explore ERI and acculturation-related variables in the context of the RBP intervention, and one of the first studies to examine ERI as a moderator of treatment outcomes in a school-based intervention. Findings have direct implications for informing RBP adaptation in order to better meet the needs of culturally diverse RBP participants experiencing socioemotional difficulties. More broadly, results speak to the importance of developing and implementing culturally adapted, identity-focused interventions for ethnic/racial minority youth in schools.