Meta-analysis: Are Psychotherapies Less Effective for Black Youth in Communities With Higher Levels of Anti-Black Racism?
- Forfatter(e)
- Price, M. A. Weisz, J. R. McKetta, S. Hollinsaid, N. L. Lattanner, M. R. Reid, A. E. Hatzenbuehler, M. L.
- År
- 2021
- Tidsskrift
- Journal of the American Academy of Child & Adolescent Psychiatry
- Sider
- 04
- Kategori(er)
- Etniske minoriteter
- Tiltakstype(r)
- Psykodynamisk/interpersonlig terapi
- Abstract
OBJECTIVE: : We examined whether anti-Black cultural racism moderates the efficacy of psychotherapy interventions among youth.
METHOD: : We analyzed a subset of studies from a previous meta-analysis of five decades of youth psychotherapy randomized controlled trials. Studies were published in English between 1963 and 2017 and identified through a systematic search. The 194 studies (N = 14,081; ages 2-19) across 34 states comprised 2,678 effect sizes (ESs) measuring mental health problems (e.g., depression) targeted by interventions. Anti-Black cultural racism was operationalized using a composite index of 31 items measuring explicit racial attitudes (obtained from publicly available sources; e.g., General Social Survey), aggregated to the state level and linked to the meta-analytic database. Analyses were conducted with samples of majority (i.e., >=50%) Black (n = 36 studies) and majority-White (n = 158 studies) youth.
RESULTS: : Two-level random effects meta-regression analyses indicated that higher anti-Black cultural racism was associated with lower ESs for studies with majority-Black youth (beta = -0.2, 95% CI: -0.35, -0.04, p = .02) but was unrelated to ESs for studies with majority-White youth (beta = 0.0004, 95% CI: -0.03, 0.03, p = .98), controlling for relevant area-level covariates. In studies with majority-Black youth, mean ESs were significantly lower in states with the highest anti-Black cultural racism (>1 SD above the mean; g = 0.19) compared to states with the lowest racism (<1 SD below the mean; g = 0.60).
CONCLUSION: : Psychotherapy randomized controlled trials with samples comprised of majority-Black youth were significantly less effective in states with higher (vs. lower) levels of anti-Black cultural racism, suggesting that anti-Black cultural racism may be one contextual moderator of treatment effect heterogeneity.