Youth mental health: Racial trauma and stress

Farzana (Saleem) Adjah (00:00):

So we want young folks to be able to name it, be able to resist, be able to respond, and then ultimately be able to thrive.

Denise Pope (00:12):

Today, once again, we're looking at the mental health of our students, a subject you all know is near and dear to my heart. In fact, we're going to spend several episodes this season on mental health issues. It's that important. In this show, we'll be focusing on racial trauma and stress and the effect that it has on all of us.

Dan Schwartz (00:33):

It's an important conversation. Are you feeling ready for it?

Denise Pope (00:36):

Definitely. Let's get into it.

(00:41):

Welcome to School's In, your go-to podcast for cutting-edge insights in learning. Each episode we dive into the latest trends, innovations, and challenges facing learners. I'm Denise Pope, Senior Lecturer at Stanford Graduate School of Education and co-founder of Challenge Success. And I'm with my co-host, Dan Schwartz, Dean of Stanford GSE and the Faculty Director of the Stanford Accelerator for Learning.

Dan Schwartz (01:10):

When I think about mental health and things that create a threat to mental health, I think of things like unstable housing, poverty, a fractious home. In 2021, the Center for Disease Control, the CDC, declared racism as a mental health threat. And in some ways it surprised me because it was just a category I wouldn't have put there. But then when I heard it made complete sense...

Denise Pope (01:37):

Oh, yeah.

Dan Schwartz (01:39):

... that racism would be a tremendous threat to mental health.

Denise Pope (01:42):

Yeah, unbelievable. I mean, we've known this for years, right? If you think about structural racism built into the system and someone's trying to buy a house in a neighborhood that's been redlined or try to get healthcare, there's so many examples that this should not be a surprise to anyone, that it's a huge toll on your mental health.

(02:07):

I think what's even scarier is you've got two things happening. You have structural systemic racism, and that's really hard to wrap your head around, like, "What can I do as an individual to change that?" But then you also have just the day-to-day unrelenting attacks on your identity. But this is why we are really lucky to have an expert with us today.

(02:27):

So I'm very excited to introduce a leading expert in trauma and racial bias in schools. Dr. Farzana Adjah is a professor at Stanford Graduate School of Education. Her research focuses on the impact racial stressors have on health, wellbeing, and academic success. So right up my alley, right? Farzana has experience providing therapy to children and adolescents, and beyond delivering treatment, she's consulted and coached others in trauma-informed evidence-based intervention in schools. So we are so glad you're here. Yay. Welcome.

Dan Schwartz (03:04):

Welcome, Farzana.

Farzana (Saleem) Adjah (03:05):

Thank you all. Thank you for having me.

Denise Pope (03:08):

We were just opening this up, but you're the expert here, so give us some definitions, maybe help us define racial bias and trauma in particular.

Farzana (Saleem) Adjah (03:18):

Yeah. We were talking earlier when you all started too about this idea of structural racism versus interpersonal racism. And so I think that just making sure folks are on the same page about that too, thinking about systems, policies, and practices that are biased based on race and that cause different disparities over time versus the interpersonal piece, we think about that day-to-day interaction, and that's maybe one-to-one, whether that's racial bullying or teasing or racial slurs that you might hear. And so thinking about the different forms of racism or race-related stress that might happen.

(03:56):

And then I think you also asked about thinking about the definition of trauma or trying to understand the definition of trauma. And so what folks might say is there is some really stressful, life-threatening event that happens to an individual that poses a threat to physical or psychological integrity. So there's something that poses this threat to safety, and then that can have consequences on different outcomes. So for example, people might have intrusive thoughts. So maybe you're having thoughts about the situation that happened or nightmares. You might feel more like hypervigilant or overstimulated or aroused. You might have different cues or reminders maybe when you're visiting that place that trigger that trauma response, as well as just psychological symptoms, so maybe worry, stress, sadness. So it can result in these different types of symptoms as well as impact focus in other areas too.

Denise Pope (04:57):

So I think when people think of schools, and I'm going to generalize, I think when people think of schools, you tend to think of safer places, places where adults care about kids. How does this play into then kids in schools? Because we know that there's structural racism built into schools, but tell us more.

Farzana (Saleem) Adjah (05:15):

Yeah, so I think the one thing that I consider a lot is there are kids coming into the school context with a whole life outside of school, which we know. And so the experiences that they have both outside of school that they're bringing in show up in the classroom. And so for example, sometimes trauma experiences or trauma symptoms even can show up and be conflated with other types of challenges that youth might have, for example, ADHD. So difficulty sitting still or being fidgety, having outbursts or being triggered. So sometimes we're thinking about how children are showing up in the classroom context. I think a lot about how trauma is important for teachers to have this trauma-informed lens and culturally-responsive trauma-informed lens when trying to interact and understand student behavior and make sense of what might be going on.

(06:06):

And then I also think about, to your point too, of thinking about the perpetuation of things that might happen within the school context that could also be stressful or traumatic for young people. And so we know that youth spend a lot of time in schools, particularly in K-12. And so that time that they're spending in schools, things might happen in the school context that they're trying to make sense of, that they're trying to even process. So that could be things like racial teasing, racial bullying, could be experiencing something traumatic that happens within the larger school context. And so students are coming in with these experiences, but then it's also possible that they're having encounters that are stressful or traumatic actually within the school context too.

Dan Schwartz (06:47):

Before we consider the things you might do about this to ameliorate it, I'm a teacher, am I going to be able to tell if a kid's coming in with trauma, like they act out and they didn't use to or a change of behavior? What are the kinds of things I should look for where I might then go get some help?

Farzana (Saleem) Adjah (07:08):

I think that it's not going to possible to necessarily give a diagnosis, so to say, "This child is definitely dealing with trauma," unless they report, and maybe you know of something directly where, "Okay, this family just had a parent maybe get removed from the household or experienced a car crash," or whatever it might be. So it's possible you might have that information and then you might notice changes in behaviors. And also to just acknowledge too, not everyone responds the same to something. So there could be one child that experiences the same type of adverse event, but they might have a different reaction to it. And so I appreciate that young folks are able to develop strategies around these kind of skills or coping when difficult things happen, although it's unfortunate that these things even happen in the first place, but just recognizing that each child will react differently.

(08:00):

So I think you could be able to identify some things that might inform, "Hey, I wonder if there might be something going on related to mental health or trauma here." So if you do see changes in behavior, if you've known a student for a while and you've noticed maybe they're more fidgety, they're more restless, they're having more difficulty concentrating, maybe they do have outbursts, so it could look more like outbursts. It could also look like withdrawal. So going from that more externalizing and/or internalizing, depending what might be going on with them or how they might be processing it. Sometimes they might be more disengaged within the classroom context. So again, that difficulty with focusing or maybe even having intrusive symptoms or just being really consumed with what might be going on with them. So it could look like disengagement within the classroom context as well.

(08:50):

I think looking out for some of those changes, or if you are newer to learning a student and you notice a pattern of these behavioral markers, I think it should put up an antenna to say, "Okay, I wonder what might be going on." And then hopefully there are other resources too where maybe you could talk to a school counselor or figure out if there are other resources or information about what might be going on with the student if you don't talk directly with them. So those are a couple of suggestions.

Dan Schwartz (09:24):

I've heard the assistant who works the front desk at the school is probably the best at being able to see changes coming in the door.

Denise Pope (09:34):

Okay. Why do you think that, Dan?

Dan Schwartz (09:34):

The parents come in with a child, and I think the parent's behavior is more transparent at revealing that something's going on, that there's been a change. The kids coming into school late with the parents, things like that.

Denise Pope (09:48):

I was going to say, I mean it's not surprising because I would say they also know all the absentee rates, and often they're the ones that call home. I don't know if people know this, but in some schools, when your kid doesn't show up, there is a call home to see if everything's okay. But also with adolescents, it's to make sure that they're not ditching or doing things that they shouldn't. So they have a lot of the knowledge.

Dan Schwartz (10:17):

Farzana, I hate to put the burden on the kid. So there's a child who's going into situations where their racial identity is being threatened, they're getting some self-doubt about with their positioning, ideally the school would be able to create supportive environments. But are there things you can do to help children? I know you work on this, to try and get children a good framing for interpreting what's happening. How do you do this?

Farzana (Saleem) Adjah (10:50):

My colleagues and I co-developed a group-based intervention that's helping youth essentially be able to gain strategies for understanding what might be going on as youth might be making sense of different race-related stressors, navigating identity or challenges around just racial identity development, and then trying to heal from the consequences. So I think the beginning of the podcast we had talked about racism as a public health threat or concern and the consequences of race-related stressors. And so the intervention is also designed to help think about strategies to promote healing and resistance.

(11:27):

A few things that we've found that we're examining and we're looking at based on both theory and some of the research within the literature is sometimes it's having vocabulary. A lot of times when you can name what's happening to you, you can make more sense of it. So it's like, "Okay, I am having chills and I'm having a fever and I can't breathe. Okay, maybe I have the flu. Oh, there's something going on. Now let me figure out how to resolve the issue." And so similarly, I think when youth are experiencing these things, sometimes they already have the language because maybe they have parents or they have even peers in the adolescent developmental period or family members or other folks in the community who talk to them about this stressor that could happen. But that language is really important, I think the recognition, the critical consciousness, the ability to name and analyze and recognize systems of oppression. So that's one piece, so having the language around understanding and awareness,.

Dan Schwartz (12:24):

I think I'd have a hard time talking to kids giving them definitions. Some of them are experiencing this, so it's a dangerous situation. So how do you do it?

Farzana (Saleem) Adjah (12:34):

Yeah, we have different strategies within the content. So it's group-based, so very community-based setting, and we do different things. One strategy that I think has been helpful is we actually have animated content. So when we created the intervention, we had a community advisory board of young people and then adults who are in different child serving settings, so juvenile justice schools and different roles, for example and so they provided feedback. Members of the community advisory board and the development team actually shared their experiences, and we have those as animated videos that accompany each of the gatherings that we have within the intervention. And so, one way to do it is they're seeing an animated video of a real person's experience and it's narrated by us. And then again, it's an experience from our young adulthood or childhood. And so they can even see the symptoms or hear what's going on and see what's going on in the video.

(13:33):

And then sometimes they might be able to relate to it, sometimes they might not be able to. But I think having, especially as a young person, and even as adults, sometimes it's easier for us to see things in other folks and then say like, "Huh, okay, I can make sense of that. I can grapple with that," and then be able to grapple with the fact that this might be happening with me or it might be a personal experience I'm having. So we've used experiences. I think narratives and testimony is a big part of the process of thinking about healing, so having this collective space and folks sharing experiences is one way.

(14:07):

There are some practical definition pieces where we have youth go through and ask, "Have you heard of discrimination? What does that mean to you? How do you define that?" Because also the terms that we use as adults, these terms are very often not how youth are going to define them or talk about them. And so we also give a lot of autonomy and space for them to be able to define, and then we provide scaffolding around helping them understand these different terms and experiences. So there's different modes that we use to try to get them engaged and facilitate discussion and awareness of the topics.

Denise Pope (14:42):

So awesome, so important. You have to name what's going on in order to really understand it and work it out. I've heard that as a general strategy for all youth and adults even. So maybe walk us through what some of the specific strategies are that really are race specific in this case.

Farzana (Saleem) Adjah (15:03):

Three other strategies that we implement and we teach within the TRANSFORM intervention beyond naming is then resisting. So how do I, for example, not internalize? When these things are happening to me, we don't want young people to internalize and think there's something wrong with them. We want them to be able to say, "Okay, there's something wrong with this system. There's something wrong with this individual's beliefs that they have. There's nothing wrong with me." And so part of that is thinking about the connection even between understanding what's happening in your environment and then how you're interpreting in that information, connecting thoughts, feelings, and actions, which are also a general strategy, but naming, "Do I think this is based on historical things that have happened or something that is specific to race within the context of this situation?"

(15:54):

So if I'm being followed around in the store and if I notice that me and my friends every time we go into the store we're being followed around, how do I make sense of that? And then how do I make meaning of that? So there are strategies that they can do in terms of deciding to say, "This isn't something that I've done. I know I came in, I intended to pay. I won't be patronizing the store anymore, so I won't be coming back in. And this is nothing that I've done wrong." So being able to say, "I think that person has a racial bias, because every time a group of my friends maybe come in and we're Black, we look different, or we're of a different racial group, I notice that this pattern continues to happen." So the resistance strategies both around how to respond and then how they're making sense of it.

(16:37):

And then in part of the response piece too is we do practical strategies of even within respond or response acronyms. So what do I do in the situation? Because oftentimes young people say, "I feel frozen" or "I feel really angry and I maybe want to punch someone in the face when these things happen." So how do we utilize a safe strategy for what to do? And so thinking about, okay, maybe I report, maybe I tell a trusted adult. I document the incident. So thinking about different ways to teach them to respond, and then also thinking about things like critical action. So a part of critical consciousness too is the ability to think about, "Okay, what are things that I can do? Again, I'm not going to fix the system." There are policies and practices that also are happening, and so we're not putting it on the child to say, "Fix this issue." But at the end of the day, we also know that young people need strategies on how to manage these things in their lives and not internalize it, again, because this is a characteristic that they were born with, thinking about the color of your skin or your culture or your heritage, of having people treat you differently because of these situations or not feeling represented within your curriculum or course content, whatever the level of race-related stressor or racism might be.

(17:52):

And so we want young folks to be able to name it, be able to resist, be able to respond, and then ultimately be able to thrive. What does it look like to build a healthy sense of ethnic racial identity? We know that having a healthy sense of ethnic racial identity for young people of color, that is a buffer against race-related stressors. So we tend to see that having that sense of cultural pride, knowing about your heritage, knowing the strengths of your cultural group, knowing how your cultural group has overcome or even use strategies around resistance or empowerment. So these different strategies can reduce the impact of race-related stressors. And so thinking about that thriving piece is also very important, and we embed that through the critical action as well as building a sense of cultural pride and cultural assets.

Denise Pope (18:41):

It's awesome, and I think a lot of adults forget that asking a child to do something about it is putting a lot on the kid. So I love that you have these options of very concrete things that you can do, right? This happens to you, there's very concrete things you could do. The onus is not on you to change the system. But there's also that sense of working with the adults to help them understand this. You mentioned even just the example of if you don't see yourself represented in the curriculum what that might do for a child. I know that there's this notion of culturally sustaining pedagogy, culturally sustaining curriculum, culturally responsive curriculum. So what are some of the things that you tell adults to help take the onus off of those kids having to make all of that changes themselves?

Farzana (Saleem) Adjah (19:40):

Within TRANSFORM in particular, so we actually try to train folks embedded within the child serving context. And so we work with adults within the child serving context to deliver the intervention. So the idea is that the skills and the strategies will stay within that context, or maybe even they'll spread it to other folks. They'll also be able to be disruptors of racism. So that's an example of thinking about... They participate in a training.

(20:04):

A lot of the initial work is doing some self-reflection, like thinking about your own perception of your racialized identity. When did you first learn about your racialized identity? What does that look like? What type of privileges and power do you hold? How do you think about the intersections of your identity? Because there are certain aspects of our identity where we hold more privilege and power. We can think about race, we can think about education, we can think about gender.

(20:32):

So really the processing at the individual level and the reflection at the individual level, and then thinking about, "Okay, what are strategies that I can do?" They're walking through the curriculum themselves, they're learning the strategies that they're teaching young people, but they're also learning what it means to be disruptors. So when they see something happening within the school context, whether that's peer to peer, whether that's adult to peer, how can they intervene? And so, one of the things that we measure essentially is an aspect of racial socialization competency, essentially it's a self-efficacy to be able to respond to racism that happens or race-related stressors. So how confident do I feel to name or call out a student or a colleague that makes a racist joke or comment? How confident do I feel to correct some sort of microaggression that I see perpetuated within this context? So assessing their self-efficacy and being able to respond. And so that's one thing that we hope that both young people and adults who participate gain that self-efficacy to be able to respond and disrupt when that happens.

Dan Schwartz (21:40):

So Farzana, I'm going to switch for a second or maybe for the rest of the show. This is Stanford. We are in Silicon Valley. It means you must be using technology somehow.

Denise Pope (21:52):

Oh my God.

Dan Schwartz (21:54):

So tell us about what you're doing with technology to see how you can advance this work.

Farzana (Saleem) Adjah (21:59):

Yes. Another line of the work that's related to this too, I think a lot about practical strategies to help adults and young people. And so one project that we're working on is a virtual classroom study and we are recruiting teachers and we're trying to understand how they respond to students' questions about race-related topics and even student race-related distress within the virtual classroom environment. And so teachers are instructed to read a book that primes them for conversations about race-related topics. The first part of the study, it's kind of unstructured, they're coming in with a lesson plan, and then the second part is more structured, so the virtual students actually ask specific questions.

Dan Schwartz (22:46):

Hang on, I have a headset on and I see three cartoon character-ish kids in a classroom, and I am in the front of the classroom teaching. The kids are nodding slowly because that's what happens in those. And then eventually the kid says something and I, as the teacher, need to respond to this synthetic character who's playing out a role. Do I have it right?

Farzana (Saleem) Adjah (23:16):

Exactly. There's no headset. So it's technically mixed reality, which I had to get schooled on quickly. It's different from virtual reality.

Denise Pope (23:25):

Okay. What does that mean?

Farzana (Saleem) Adjah (23:27):

So they're logging into essentially a Zoom platform. You can think about it as a virtual Zoom platform. And so they're coming in and then they see within the Zoom screen a virtual classroom of students, and each student has a name tag in front of them, and then there is a person that's controlling what the students can say. So there is a script to what the students say, but then there's a little bit of free flowing. So we have the teachers, again, at the beginning, they're teaching, and then the second part, they're responding to student questions.

Dan Schwartz (23:58):

Does it work? Does it work?

Denise Pope (24:00):

Yeah, that was my question too.

Farzana (Saleem) Adjah (24:03):

Yeah, we've been asking teachers post their engagement in the virtual classroom, we ask them, "How did it feel? What was it like?" I think they said that it felt like a good space for doing training. Of course, it feels different from being with real students, but it feels like a safe space. Also thinking about mitigating harm, because I think when teachers are trying to practice what does it look like to be affirming when a student discloses... I think one of our virtual students discloses being called a racial slur. And so figuring out how the teacher navigates that and trying to code and look for patterns of how are teachers responding to these different questions that students ask, and then also how are they engaging in these conversations? We also know that conversations about race or DEI in general around different parts of the country have been shut down.

(24:51):

And so we need to think about how important this topic is in terms of having conversations about race within the classroom, about equity and inclusion also within the classroom. So for example, at the beginning part of the simulation, we noticed that there are fewer race-related words that teachers are using unprompted when they're teaching compared to when prompted by student-specific questions. So we're even doing a deep dive right now, it's looking at trying to understand the patterns that are coming up in the unprompted teaching compared to when they're responding to these specific questions that are being asked by the students to the teachers. Eventually our goal is to figure out how do we help teachers be able to increase their self-efficacy and confidence and skills to respond to student race-related topics and distress within the classroom.

Denise Pope (25:51):

It is so important the work that you are doing. As a teacher or educator, you want to know how to show up as much as you can for the kids. It's really great that you've provided a space where they can learn how to better respond to these race-related stressors, which we know are just so difficult and you don't get a lot of training around. So thank you so much for the work with the adults and with the kids too.

Dan Schwartz (26:16):

Agreed. Thank you, Farzana, for sharing all this with us today. You mentioned, and it's so important to remember, that every kid can respond to a stressful and traumatic situation differently. There's no right answer, but there are ways to help kids navigate those moments to protect them from further harm.

Denise Pope (26:32):

Exactly, Dan. I love the strategies where you teach them how to name it and resist it and how to respond to it, and then ultimately really to get beyond it and to carry on and thrive. I think at the end of the day, all of us just have to do our best as educators to really listen to the kids and look for any changes in their behavior that's concerning, anything that worries us, and obviously to always speak up when you see something of concern.

(26:59):

Well, thank you again to Farzana, and thank you all for tuning into this episode of School's In. Remember to subscribe to our show on Spotify, Apple Podcasts, or wherever you tune in. I'm Denise Pope.

Dan Schwartz (27:10):

And I'm Dan Schwartz.