The intersection of family and community resilience to enhance mental health among Latino children, adolescents, and families
Currently, there are 22 million Latino children under the age of 18 residing in the United States, thus comprising the largest minority group of children (Fry & Passel, 2009). Within the Latino grouping are all persons whose genesis is traced to the Spanish-speaking regions of Latin America, including the Caribbean, Mexico, Central America and South America, and include national subgroups with different histories, a common language and cultural values that are shared (Clauss-Ehlers & Lopez Levi, 2002). Despite this demographic change over the past several years, meeting the needs of this population remains a critical issue. In fact, Flores et al. (2002) identified several critical priorities specifically related to this population, including the need for better research instruments that are validated for the Latino population, increased understanding of culture, literacy and education of this population, and the need for further exploration as to the causes of mental health disparities among Latino youth. Despite the calling of attention to this critical matter in 2002, it appears that gaps in knowledge and understanding related to the disparities among Latino children remains of such grave concern that agencies such as the National Institute of Health have put out calls for research specifically addressing the reduction of health disparities amongminority and underserved children. One way in which to begin exploration of this critical issue is through the lens of resilience.
The concept of resilience has been defined as the capability to flourish despite normative fluctuations that take place throughout the life span (Bonanno, 2004; Seligman & Csikszentmihalyi, 2000). Originally, resilience was examined from an individualistic perspective, wherein specific traits or characteristics were postulated as being responsible for the success of some individuals (Higgins, 1994). However, resilience can be learned over the lifespan and fostered through supportive relationships or interactions. The concept of resilience has been further expanded to not only include individual perspectives but larger support networks.
Within a familial context, resilience refers to a family’s ability to positively adjust in light of challenging life events or stressors (Luthar, Cicchetti, & Becker, 2000). This perspective originates from a systemic view wherein the presence of vulnerability processes and protective processes are conceived to interact reciprocally, thereby affecting the functioning of a family and all its members in a circular manner (McCubbin & McCubbin, 1991). Stemming from the work within the area of family resilience, the Family Adaptation Model posits the following: family adaptation results from ongoing development and successful use of protective factors, family vulnerability creates the demands on the maintenance of protective processes and also allows for greater opportunity for the development of successful protective processes, and the dynamic between protective and vulnerability family processes can be captured by five dimensions which include adaptation, demands, appraisals, supports and coping (Drummond, Kysela, McDonald, & Query, 2002). Within this framework, appraisals, supports and coping strategies represent the protective family processes, while demands represent the vulnerability family processes (Drummond, Kysela, McDonald, & Query, 2002). The protective family processes thus interact with the demands/stressors to predict family adaptation. Family resilience and adaptation have been extensively investigated. According to Hjemdal (2007), publications relating to resilience and protective factors have increased by 85 percent, and the concept has been explored in children of mothers diagnosed with severe mental illness (Tebes, Kaufman, Adnopoz, & Racusin, 2001), in families confronted with chronic illness (Carver, Smith, Antoni, Petronis, Weiss, & Derhagopian, 2005), and in families experiencing economic decline in the Midwest (Conger & Conger, 2002). Yet, an area that remains underexamined is ways in which minority cultures use cultural values as mechanisms of resilience.
A Latino perspective of resilience
Key characteristics of resilient families include warmth, affection, cohesion, commitment and emotional support for one another (McCubbin & McCubbin, 1988; Seccombe, 2002) — these are all cultural values inherent within the Latino culture. Familismo is the formal term that refers to an emphasis on family relationships and social support networks that can be comprised of first-degree relatives or extended family members (Raffaelli & Ontai, 2004). In essence, this concept mirrors the supports postulated by the Family Adaptation Model. Additional parallels between factors posited by the Family Adaption Model and cultural mechanisms in Latino culture have been identified. In fact, Marin, Huber, and Montoya (2007) found a significant positive relationship between la adaptabilidad (adaptive appraisal), la sabiduría (compensating experiences/coping strategies), and familismo/pariente and life satisfaction among 77 Latinos/as aged 65 and older. Marin and Huber (2011) expanded this examination by looking at the association between la adaptabilidad (adaptive appraisal), la sabiduría (compensating experiences/coping strategies) and familismo/pariente and life satisfaction in older Latinos/as reporting increased anxiety. Positive relationships were again noted despite reports of increased anxiety. Although these examinations took place among Latinos/as aged 65 and older, it is proposed that these same variables would hold true for younger persons of Latino descent, given the shared cultural values.
Resilience is not a factor that exists solely within individuals or among families. It is a phenomenon that can be applied to communities and social policies in an effort to reduce health disparities. In fact, Seccombe (2002) suggests that resilience can be embedded within social policy for greater familial success. Without changes to social policy, disparities among children, youth and families will persist. An example of policy changes needed includes greater healthcare coverage. Despite programs such as Medicaid and state Children’s Health Insurance Programs (CHIP), many persons remain uninsured. Arguably, policy change wherein all citizens are offered medical benefits would increase family resilience by removing the stressors associatedwith financing health care (Seccombe, 2002).
The intersection of family and community resilience
The question that arises is, “How can family and community resilience come together to foster the mental health of Latino youth?” The answer is all encompassing and not intended to point blame toward individuals, families or communities for not being more resilient. Clearly, one area that has consistently emerged is the need for culturally competent mental health providers who can understand the needs of minority children and provide linguistically appropriate services for diverse children and families (Kodjo & Auinger, 2004). This gap could easily be addressed by counselor preparation programs. Most accredited programs offer multicultural counseling as a program component; however, more can be done. In addition to such courses, collaboration between universities with counselor preparation programs is needed. A suggestion is to offer “mini exchange” opportunities wherein students can have the chance to travel to areas during a semester where practicum opportunities to work with diverse clientele and faculty are provided. Furthermore, continued emphasis on a strengths-based perspective is needed, rather than a continued focus on pathological issues. With regard to underserved populations, there is sometimes an assertion that minority parents are less likely to seek out treatment and may be more concerned about the negative effects of mental health services (Gudino, Lau, Yeh, McCabe, & Hough, 2008). Yet, system wide interventions and collaborations are underutilized. Another suggestion is for increased collaboration among schools and community agencies. Often, school systems are the first to work with students and families considered to be underserved. Schools and community agencies could partner together to establish after-school programs that are geared toward increased mental wellness, thereby decreasing the stigma typically associated with seeking out mental health treatment. This could be posited as a means of ensuring whole person/family wellness academically, socially and interpersonally.
An additional approach to work with Latino families is to provide support through the churches. Two advantages can be noted: first, churches provide a natural place to receive support, and second, they can help take away the stigma associated with receiving counseling services. Finally, sending education materials on what counseling is and what the benefits are can be a good way to provide parents with education related to counseling. These might need to be presented in both English and Spanish. A family night where these educative materials are presented can be a start. It is hoped that these sessions can provide families that might need assistance with an avenue to seek more counseling sessions.
Overall, seeking to reduce mental health disparities among children, youth, and families is an ecological issue and one that if appropriately addressed can have far reaching positive consequences upon our society. Yet, it is an area that requires mental health providers and counselor preparation programs to come out of their silos and engage with the community to inflect complete system-wide change.
Dr. Merranda Romero-Marin is an assistant professor at the University of Texas in El Paso. Her research interests include resilience, border health issues, effects of war and violence on family and community systems, and evidence-based treatments for Post Traumatic Stress Disorder (PTSD). Also, as a licensed psychologist, Marin has worked for the Department of Veterans Affairs, specifically with returning veterans diagnosed with PTSD.
Dr. Enedina García Vazquez is associate dean and deputy director of the Physical Science Laboratory and is Professor of Counseling and Educational Psychology at New Mexico State University. Her research interests include social, cultural, and emotional factors related to academic success; acculturation in children and adolescents; assessment strategies with diverse populations; and intervention techniques. She has been awarded the Psychological Society of Ethnic Minority Issues Service Award and the NASP Presidential Award for Exceptional Service to Children and NASP.
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