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Please no plagiarism and make sure you are able to access all resources on your own before you bid. You need to have scholarly support for any claim of fact or recommendation regarding treatment. APA format also requires headings. Use the prompt each week to guide your heading titles and organize the content of your initial post under the appropriate headings. Remember to use scholarly research from peer-reviewed articles that is current. Please follow the instructions to get full credit for the discussion.
Each classmate’s document is attached.
your classmates’ postings.
to your classmates’ postings.
Respond in one or more of the following ways:
- Share a new insight or perspective you learned or thought of in terms of advocacy in reading your colleague’s portfolio
- Share with your colleague how you think power, or privilege, or oppression may impact or influence the target problem at institutional, community, or public policy levels.
- Share a suggestion or new insight with your colleague about collaboration to influence public policy.
Classmate (J. Cosme)
Classmate (S. Danziger)
Classmate (J. Herring)
Pirog, M. A., & Good, E. M. (2013). Public policy and mental health: Avenues for prevention. In R. K. Conyne & A. M. Horne (Eds.). Prevention practice kit: Action guides for mental health professionals (pp. 1-79). Thousand Oaks, CA: SAGE.
Multicultural and Social Justice Counseling Competencies. (2015). Retrieved October 27, 2015, from http://www.counseling.org/docs/default-source/competencies/multicultural-and-social-justice-counseling-competencies.pdf?sfvrsn=20
Document: Faculty Spotlight: Dr. Christie Jenkins (Word document)
Substance Abuse and Mental Health Services Administration (SAMHSA): Prevention of Substance Abuse and Mental Illness. Retrieved from https://www.samhsa.gov/prevention
I NEED THIS TODAY 07/18/2020 BY 6PMPlease no plagiarism and make sure you are able to access all resources on your own before you bid. You need to have scholarly support for any claim of fact or recom
COUN 6785: Social Change in Action: Prevention, Consultation, and Advocacy Social Change Portfolio J Herring Contents Introduction Scope and Consequences Social-ecological Model Theories of Prevention Diversity and Ethical Considerations Advocacy INTRODUCTION Advocating for Minority Adolescents in Sanford, Florida The phrase school-to-prison pipeline is now trite, overused, and watered down, although the seriousness of the practice remains a real concern. Across the country, suspensions and expulsions from school, referrals to alternative schools, and school-based arrests have increased, especially among minority students, which blurs the line between the education and criminal justice systems. The consequences adolescents face for their behavioral issues address only the behavior but not the cause of the behavior. The socioeconomic disadvantage of minority adolescents can have significant adverse effects on their mental health, including depression and behavior problems, anxiety disorders such as posttraumatic stress disorder, and a range of other adjustment difficulties. Many minority adolescents also experience “compounded community trauma” which has been defined as the experience of children when they witness violence in both their homes and their neighborhoods. Additional factors that increase the risk for mental illness for minority youth are neighborhood exposure to violence, repeated experiences of discrimination, and chronic exposure to racism. As a result, early interventions for minority adolescents, intended to maximize their effective coping in these disadvantaged and at-risk environments, can be advantageous for their future mental health. Thus, effective adovacation that push for early prevention and intervention are essential to reduce the burden of mental disorders for minority adolescents (El Bouhaddani, et. al., 2019). PART 1: SCOPE AND CONSEQUENCES Advocating for Minority Adolescents in Sanford, Florida The conditions in which a person is born, grows, lives, and works have a significant impact on his health, both physical and mental. Sanford is the County Seat of Seminole County, Florida. Sanford has an African American population of 30.5%. The high school and its cluster schools reflect the dichotomy that exists within the community of Sanford. While Seminole High (where I once taught English Language Arts) was awarded the Silver ranking in 2015 by US News & World Report, the percent of disadvantaged students who were determined proficient was 46.5%, whereas the proficiency of non-disadvantaged students was 74.5%. In addition, the suspension and graduation rates for students of color are disproportionate when compared to white students. Sanford became the center of national and international media attention following the February 2012 fatal shooting of Trayvon Martin, a 17-year old African American high school student. However, when the marches and protests dissipated, so did the care and concern of the youth in Sanford. They were left with the invisible scars from the overt racism they faced and continue to face for looking, acting, and existing like Trayvon Martin. These children need effective mental health care to teach them coping and anger management strategies and tools, not expulsion from school. The mental health needs of minority adolescents are not well served: they are treated less frequently, and when they are treated, the services they receive are less frequently and adequate. Recent studies show that 6.6% of ethnic minority children and youth receive services compared to 20% of white children (Yasui, 2014). The result of insufficient mental healthcare for minority adolescents is that they are more likely to engage in problematic behaviors later in life, such as increased depression, anxiety, engagement with deviant peers, involvement with violent crime, poor academic performance, school dropout, drug and alcohol abuse, unsafe sex, and unemployment (Alegria, Vallas, & Pumariega, 2010). Therefore, my goal is to push for effective adovacation that provides resources for early prevention and intervention to reduce the prevalence of mental disorders for minority adolescents. PART 2: SOCIAL-ECOLOGICAL MODEL Advocating for Minority and Adolescents in Sanford, Florida One cannot deny that disparities exist in the mental health care arena, much like in general healthcare. Strategies to lower or remove discrepancies involve improving access to care, improving quality of care, and reducing the stigma associated with mental healthcare. Because of these discrepancies, some of the risk factors exist. However some risk and protective factors for minority adolescents are common for all adolescents, as this is an important time for physical, emotional, and mental development. However, if this stage of development does not occur in a safe, supportive environment, then a mental disorder may occur. Individual Some of the risk factors on the individual level for adolescents include having low self-esteem, insecure attachment, difficult temperament (poor concentration, inflexibility, low positive mood), poor social skills, and extreme need for approval and social support. Although effective treatments exist for many mental disorders, unfortunately, over half of adolescents in the U.S. who need mental health treatment never receive it. Further, compared with their white counterparts, growing evidence indicates that racial/ethnic minority adolescents are more vulnerable to mental disorders but less likely to use mental health services. Minority adolescents’ underutilization of mental health services is exacerbated by their tendency to withdraw prematurely from treatment. Adolescents will not fully benefit from mental health services if they terminate treatment early (Yasui, 2007). Another risk factor is the idea that minorities may also receive inferior care because there may be little to no diversity among the mental healthcare workers who have a decreased understanding about the different mental health needs across minority groups. This insufficient or lack of diversity begets cultural insensitivities that lead to negative health outcomes, including lower treatment retention rates (“Understanding barriers to minority mental health care,” 2018). On the other hand protective factors include having physical development, high self-esteem, academic achievement, emotional self-regulation and good coping and problem-solving skills on the individual level. Sufficient mental healthcare programs must be in place to teach minority adolescents how to implement such protective factors. Family Some risk factors on the family level are parental depression, parental divorce, poor parenting, negative family environment, child abuse, parent(s) with mental disorders, and sexual abuse. When taking a closer look at the negative family environment factor, one cannot ignore that African American umemployment rates are typically double that of Caucasian Americans. In addition, African American men working full time only earn 72 percent of the average salary of their white male peers and 85 pecent of the earnings of white women (“Ethnic and racial minorities & socioeconomic status,” 2008. With this information, it is not hard to understand why mental health disorders may occur, as hierarchical needs are not being fulfilled. Protective factors on the familial level include strong family structure with clear expectations, limits, rules, and monitoring on the family level. Adolescents must feel connected to and supported by their families, specifically their parents. Parents must be able to provide a stable home environment through sufficient employment, adequate housing, and sufficient access to medical and mental healthcare. School and Peers Risk factors at this level are the environment in which the minorities receive their education and their level of academic achievement. African-Americans and Latinos are more likely to attend high-poverty schools than Asian-Americans and Caucasians (National Center for Education Statistics, 2007). This results in a higher dropout rate, as the schools lack valuable resources, teachers with lowered expectations, and less rigorous curricula. In order to combat these risk factors, schools must provide mentors for support and the development of skills and interests. School systems must begin to see the connection between adequate mental healthcare and academic achievement. A protective factor is to implement evidence-based interventions for disruptive behavior versus disciplinary actions that might suspend the child from school. This only places the child back into a dysfunctional home, where he will not receive the proper care for his mental and emotional needs. Community When it comes to minorities, the aforementioned risk factors are heightened because socioeconomic barriers prevent access to care. It must be understood that socioeconomic defines more than the ability to attain proper education, financial stability, and a perception of social class. It also emcompasses the opportunities and privileges afforded to people within their community. When a community has high poverty rates, high unemployment rates, several locations that encourage risky behaviors (e.g. liquor stores, high-interest payday loan businesses), then there is little to no emphasis placed on education, proper healthcare, and positive social connections. Community protective factors provide opportunities for engagement within the school and community to create and reinforce positive norms, enforce expectations for positive behavior, and promote psychological safety (O’Connell, Boat, & Warner, 2009). While these are community protective factors, they begin in individual homes with the community providing the resources and support to prevent the perpetuation of abuse and dysfunction. PART 3: THEORIES OF PREVENTION Advocating for Minority Youth in Sanford, Florida Albert Bandura’s social learning theory is popular among current prevention programs. According to Bandura, learning is acquired and shaped by positive and negative reinforcements (rewards and punishments), as well as by observation of other people’s behavior (Johnson, 2018). This theory is based on the idea that people can predict the consequences to certain behaviors and earn the rewards or endure the punishments. Bandura recognized the potential for using modeling as a way of directing and changing behavior. This theory can serve as a framework for a mental health awareness program for minority youth as it emphasizes “using the team or buddy approach, teaming individuals, small groups, families, and even communities, in which new health related behaviors can be modeled and reinforced, helping to set new norms” (Johnson, 2018, p. 579). In this way, peer mediation and group therapy principles can be utilized to help the adolescents learn and adapt new behaviors, thus helping reduce the chances of depression, drug-use, and/or expulsion from school. In addition to school, the social learning theory can also be applied in the home-setting. Bandura believed that children learn vicariously by observing their surroundings, so if family violence is present in the home, then the children are at risk for imitating these behaviors. They are also at a higher risk for developing mental health disorders (Abbassi & Aslinia, 2010). According to the theory, once mental health professionals learn more about the home and school ennvironment, then they can put curricula in place that will prevent cycles of abuse, mental health disorders, suicidal ideation, and antisocial behaviors. PART 4: DIVERSITY AND ETHICAL CONSIDERATIONS Advocating for Minority Youth in Sanford, Florida Conducting research with minors in a school setting for preventive purposes and investigating risk or self-destructive behaviors such as deviance, drug abuse, or suicidal behavior, is ethically sensitive. This is because prevention specialists may be tempted to impose their values on this marginalized group (Hage & Romano, 2013, p. 39), although they do not have any shared experiences. Another reason mental health professionals must exercise caution is because of the historial mistreatment of ethnic minorities in a medical research setting. Historical events may bring about skepticism about the real purpose of a prevention program. The well-known Tuskegee Experiment, where over 600 African American men were intentionally injected with syphilis and not given antibiotics, which would cure them. Instead, they were given placebos, aspirin, or herbal suppliments, so the medical community could observe the disease’s natural progression in the body. As a result, the men either died, went blind or insane or incurred severe health problems due to the untreated syphilis (Green, et.al., 2013). While the Tuskegee Experiment is not an isolated incident, it does serve as a symbol of how minorities can be taken advantage of under the guise of programs of help and prevention. In addition to the exploitative research and prevention programs, there is also evidence of medical and mental health-related programs that are designed to support racist ideology. In other words, these programs are designed to show the “physical, intellectual, and emotional inferiority of minorities to justify slavery, discriminatory immigration policies, and educational segregation” (Alvidrez & Arean, 2002, p.104). Because of the aforementioned, mental health professionals must work hard to establish rapport, especially building trust, with the minority youth they are aiming to help. They must also work carefully to validate the experiences of people who may be culturally different from them. Informed consent and confidentiality are especially important with this population of adolescents because they do not have the legal right to consent, nor do they have the emotional maturity to understand the benefits and the possible dangers of participating in mental health programs. They must also understand the confidentiality has its limitations and it must be broken in some cases. Mental health professionals must understand that many minority adolecents seek validation and acceptance. If they feel these needs are being met in a therapeutic setting, but they disclose information that must be shared, then the trust that has been established may be irretrievably broken. In addition to informed consent and confidentiality, collaboration are some of the the core ethical considerations that should be taken into account when working with minority adolescents. The type of change defined in this proprosal will require systemic change; therefore, ethical considerations indicate that not only should the target population be involved in the prevention plan, but also their individual families, entire communities, and the entire school (Hage & Romano, 2013). This type of collaboration will promote trust and prevent opposing values being placed on the adolescents. PART 5: ADVOCACY Advocating for Minority Youth in Sanford, Florida Advocacy in mental health serves to promote the voice of clients, represent their interests, and encourage collaboration in decision-making. Because inequities and disparities for mental health and medical health coverage abound between minorities and their caucasian counterparts, minorities, especially adolescents, may find it difficult accessing quality mental health care. For this reason, in order to advocate for the minority youth in Sanford, Florida, certain barriers at the institutional, community, and public policy levels must be identified and dismantled. The Multicultural and Social Justice Couseling Competencies (MSJCC) provides guidance through an outline in which counselors may follow in order to identify resources and implement change. The institutional level includes schools and community programs that provide specific services and programs for adolescents. A barrier at this level is being able to provide adequate financial resources for mental health programs. The Florida Legislature created the Florida Education Finance Program (FEFP) to fund public education in a manner that would “guarantee to each student in the Florida public education system the availability of programs and services appropriate to his or her educational needs.” Funding for the FEFP combines state funds – primarily generated from sales tax revenue – and local funds – generated from property tax revenue (“Florida’s K-12 funding formula,” 2016). Many schools that service the needs of minorities are located in low-income neighborhoods, which means they do not generate enough property taxes to provide funding for extra programs, such as one that provides mental health care for the adolescents that attend the school. Any extra money the school receives is likely to go towards building maintenance, classroom resources, or academic remediation resources. Mental health care is not high on the priority list for any principal. Another barrier that was a common trend during my time as a classroom teacher is transportation. While the students may express the desire to participate in several programs offered by the school, the lack of transportation was a hindrance. However, it is feasible to expect school administrators to allocate funds for buses (gas and driver) when the building is falling apart or the school does not have adequate teachers. Mental health is not high on the priority list. The community in which these adolescents lives also set the level of importance in which mental health and mental health care is placed. According to concepts listed in the MSJCC, these values either have a positive, empowering influence or a negative, oppressive influence (Multicultural and Social Justice Counseling Competencies, 2015). As previously stated, the property taxes have a direct impact on the amount of financial resources available to certain communities. These poorer communites have residents who mostly live paycheck to paycheck, only meeting basic needs of living—food, water, shelter, and clothes. Mental health care is seen as an unattainable luxury reserved for more financially stable residents. The first step in overcoming this obstacle is the acknowledge that it exist. Oftentime, people are expected to “overcome” or “rise above” their circumstances, even when they are not provided the proper tools in which to rise above. When community leaders, such as the city council, school board, and even church leaders acknowledge the disparity of resources between the residents, then interventions may be implemented. Another barrier that likely carries the most opportunity for intervention is at the public policy level. This level involves state and federal laws and policies that directly impact communities and how well they are able to grow and thrive (Multicultural and Social Justice Counseling Competencies, 2015). Poor health outcomes for minority health, especially when it comes to mental health care, is apparent when it comes to Florida’s general population. Documented research shows that minority populaitons experience higher rates of illness and death from health conditions such as heart disease, stroke, specific cancers, diabetes, HIV/AIDS, mental health, asthsma, hepatitis, and obesity (“Minority health and health equity | Florida Department of Health,” 2020). For this reason, the Office of Minority Health was established established in 2004 by the State Legislature 20.43(9), which works alongside the Department of Health to provide consultation, training services, program development and implementation, and other necessary resources to address all of the healt needs of Florida’s minority populations statewide. References Abbassi, A., & Aslinia, S. D. (2010). Family violence, trauma and social learning theory. (Undetermined). Journal of Professional Counseling: Practice, Theory & Research, 38(1), 16–27. Alegria, M., Vallas, M., & Pumariega, A. J. (2010). Racial and ethnic disparities in pediatric mental health. Child and adolescent psychiatric clinics of North America, 19(4), 759–774. https://doi.org/10.1016/j.chc.2010.07.001 Alvidrez, J., & Areán, P. A. (2002). Psychosocial treatment research with ethnic minority populations: Ethical considerations in conducting clinical trials. Ethics & Behavior, 12(1), 103-116. https://doi.org/10.1207/s15327019eb1201_7 El Bouhaddani, S., van Domburgh, L., Schaefer, B., Doreleijers, T. A. H., & Veling, W. (2019). Psychotic experiences among ethnic majority and minority adolescents and the role of discrimination and ethnic identity. Social Psychiatry and Psychiatric Epidemiology, 54(3), 343–353. https://doi-org.ezp.waldenulibrary.org/10.1007/s00127-019-01658-1 Florida’s K-12 funding formula. (2016, April 30). Fund Education Now. https://fundeducationnow.org/ Gary, A. F. (2005) Stigma: barrier to mental health care among ethnic minorities, Issues in Mental Health Nursing Green, B. L., Maisiak, R., Wang, M. Q., Britt, M. F., & Ebeling, N. (2013). Participation in health education, health promotion, and health research by African Americans: Effects of the Tuskegee syphilis experiment. Journal of Health Education, 28(4), 196-201. https://doi.org/10.1080/10556699.1997.10603270 Hage, S., & Romano, J. L. (2012). Ethical and professional issues in prevention. In Best practices in prevention (pp. 39-46). SAGE Publications. Johnson, E., Amatetti, S., Funkhouser, J., & Johnson, S. (2018). Approaches to the prevention of alcohol use and abuse. Alcohol use among Adolescents, 103(6), 61- 88. Minority health and health equity | Florida Department of Health. (2020, April 24). Florida Department of Health. https://www.floridahealth.gov/programs-and-services/minority-health/index.html O’Connell, M. E., Boat, T., & Warner, K. E.. (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Washington, DC: The National Academies Press; and U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (2009). Yasui, M. (2014). Minority youth: Needs for mental health services grow with population. The University of Chicago School of Social Service Administration Magazine, 22(2).
I NEED THIS TODAY 07/18/2020 BY 6PMPlease no plagiarism and make sure you are able to access all resources on your own before you bid. You need to have scholarly support for any claim of fact or recom
COUN 6785: Social Change in Action: Prevention, Consultation, and Advocacy The LGTBQ Youth Community in Memphis, Tennessee S Danziger Contents Introduction Scope and Consequences Social-ecological Model Theories of Prevention Diversity and Ethical Considerations Advocacy INTRODUCTION The LGTBQ Youth Community in Memphis, Tennessee For many who identify themselves with the LGBTQ community coming out as an adolescent can be a painful process. They risk family rejection and as a result are much more likely to suffer from depression and suicide attempts. Moreover, the prejudice that they experience from society at large can lead to substance abuse and engaging in risky sexual behavior as methods of coping. Some other negative aspects of coming out can be discrimination in school and a feeling of not belonging or being ostracized from the spiritual home (Murray, Pope, & Willis, 2017). The focus of this portfolio will be the youth in this community and how to best support them. This can be especially challenging considering that Tennessee is part of the “Bible Belt” and has a history of intolerance. PART 1: SCOPE AND CONSEQUENCES The LGTBQ Youth Community in Memphis, Tennessee The target problem that will be addressed is the rate of mental health issues in the LGTBQ youth community. For the purpose of this portfolio, the scope of mental health issues will include, but not limited to; depression, anti-social behavior, risky sexual behavior, suicide risk behaviors, alcohol and drug addiction. Growing up in the South has memories attached to it, just as all regions do. The typical ones that come to mind are football, Church on Sundays, minding your manners and dating your heterosexual high school sweethearts. The South historically does not bring up images of tolerance for those who did not fit the mold. That being said, growing up under the LGBTQ umbrella in the South has gotten progressively better over the years and this is something that as Southerners we can be proud of. However, the GLAAD organization also reports that people in the South are more uncomfortable with the LGBTQ community then the US as a whole (glaad.org). This of course trickles down to the younger generation and that has a negative impact. The result being that coming out can be a risky and scary prospect to an adolescent, which in turn has an effect on the mental health of the LGBTQ youth of my community here in Memphis. What is being shown statistically is that there is a relationship between teens that are coming out as LGBTQ to their parents, being rejected and mental health issues. The result is a marked increase in depression and suicidality because of this experience. Moreover, this situation can also lead to some of the issues mentioned above such as risky sexual behavior and drug or alcohol abuse (Rusow, Goldbach, Rhoades, et al 2018). While on the national level, gay rights have improved greatly the numbers of LGBTQ youth who are struggling with mental health are still rising. The consequences of these situations are multifaceted and impact many areas of the community. The first causalities of course, are the families that are either broken or even destroyed by abending a child for being who they are. The child who is now cast out of their home may have no other place to live other than a shelter which may or may not be a safe place. Typically, though the youth will decide to live on the streets and live as homeless which impacts their ability to remain healthy both mentally and physically. Secondly it impedes their ability to attend let alone be successful in school or hold down a job. The teens can also be at a higher risk for drug and alcohol abuse which can increase crime in the community. This in turn impacts the neighborhoods and communities. In other words, the impact is felt throughout the community when a child is rejected. The goal is offering services for both teens and their parents that can offer educational and counseling services. These services can then be used to guide teens in the coming out process and support the parents once their teen has come out. Then hopefully the rise in mental health issues and suicide can be prevented. PART 2: SOCIAL-ECOLOGICAL MODEL The LGTBQ Youth Community in Memphis, Tennessee The main risk factor that LGBTQ youth face when coming out is rejection. Looking at this issue from the social – ecological model, is that the risk is a concern at all levels. When a youth comes out as LBGTQ they are risking rejection from family, friends, their community and their cultural affiliation. Moreover, the chronic stress of knowing that they may be rejected or ostracized once they do come out that can be one of the factors that lead to negative mental health outcomes (Taylor, 2019). There are other risk factors that these youth face such as victimization, discrimination, self-blame and substance abuse. What is important for the adults supporting LGBTQ youth is knowing what protective factors are necessary to mitigate these dangers. The first protective factor comes from the individual, and that can be gained from feeling pride and a strong sense of self. The development of self-esteem and self-identity ties into having resilency when there is negative feedback about being a part of the LGBTQ community (Murphy & Hardaway 2017). Moreover, these protective factors help shield the youth from negative mental health issues, substance abuse and homelessness. A risk that is taken by an LGBTQ youth when coming out to their family is being rejected. This rejection leads to higher rate of homelessness and suicidality which is a major public health heath issue for the youth in this community (Rusow, Goldbach, Rhoades, et al, 2018). The most important protective factor for teens is acceptance of their LGBTQ status by their family. The statistics demonstrate that this acceptance leads to higher levels of self confidence, physical and mental health. Moreover, teens who remain at home in a safe environment are significantly more protected from depression, substance abuse, suicidal ideation, self-harm and of course homelessness (Taylor, 2019). During the stage of life that is adolescence, the peer group and the school setting are frequently the same. When a teen comes out the importance of their peer group and school community cannot be downplayed. Similar to the teen who is accepted by the family, the teen who is accepted by their peers has a lower risk and is more protected from depression, suicidal thoughts and substance abuse. Again, they also report a higher level of self esteem, better physical health and a higher level of achievement in school. Interestingly, LGBTQ youth who have friends are less likely to suffer from the effects of victimization, that is not to say that they will not encounter it, it is just less painful and inflicts less damage. In terms of the school setting, when the school sets the tone for being open and accepting of their LGBTQ youth it does have a tendency to trickle down to the student body (glaad.org). For example when there is a Gay Straight Alliance Club on school property, it is a strong example of the school being a safe place for their LGBTQ youth. This can lead to a better sense of belonging and less victimization for the youth who has come out. Secondly, when the school teaches inclusive curriculum about the LGBTQ community as a whole this also leads to a feeling of inclusion and safety (Taylor, 2019). The issue of culture and community for LGBTQ youth is complicated, because it is dependent on how the youth defines those words. If a youth defines themselves as part of a minority, for example as a African – American, Asian – American, Latino or Jewish and they feel pride and connection to their heritage then their culture and community could be a protective factor for them. LGBTQ youth who felt pride in their culture had a statistically better chance of graduating high school, not facing substance abuse and not being homeless (Murphy & Hardaway, 2017). However, the flip side of this is that youth in these minorities were less likely to come out to their families because they would face rejection from their familes and their communities (Sue & Sue, 2016). Therefore they make the choice to stay connected to who they are in one aspect, but hide their sexuality because the consequences are too great. From the greater community stand point the change has to come from all of us, from the community as a whole. While steps are being made, such as gay marriage being legalized in 2015 and the latest ruling of the Supreme Court which bans discrimination based on sexual orientation or gender identity. These changes are important, but changes must also be made on the local and state level. However, just as importantly are the shifts in attitudes that are necessary in every home that have negative or discriminatory attitudes toward the LGBTQ community as a whole. Until that is done the battle will not be won. PART 3: THEORIES OF PREVENTION The LGTBQ Youth Community in Memphis, Tennessee This portfolio works to establish the betterment of LGBTQ youth in Memphis, Tennessee. The goal is offering services for both teens and their parents that can offer educational and counseling services. These services can then be used to guide teens in the coming out process and support the parents once their teen has come out. Then hopefully the rise in mental health issues and suicide can be prevented. In other words, to address the fact there is a problem a work to create interventions to solve that issue before it becomes a public health issue. Within the realm of prevention there is one theory that most directly works with goal stated here, that is the Ecological Theory. That theory addresses that health requires a multilevel approach and is not flat, so to speak. More tightly defined, that can be said to mean that the levels are; Intrapersonal Level where the person’s individualities are what drives the process Interpersonal Level where people’s processes within primary groups such as friends and family give support, identity and definition of roles. Community Level, which include institutional factors, community factors and public policy. Within these are norms of society, recommended behaviors and government policies (cancercontrol.cancer.gov) A second important aspect is that within this Ecological model, we influence those around us. Of course the modern example being wearing of masks. Should the majority of an interpersonal group set the example of wearing masks, then the reciprocal causation can be that others do and that moves to other interpersonal groups. Within the scope of this portfolio, and the prevention of mental health issues with LGBTQ youth, this Ecological Theory model fits quite well. The first step for a youth to come out begins with themselves, the Intrapersonal Level. Their own characteristics, knowledge, personality and beliefs will be some of the driving factors in how to handle their own personal situation. Is their belief in themselves strong enough that they will be able to withstand possibly being ostracized from their peer group for example? On the Interpersonal Level, does the youth have connections to friends or peers who are also LGBTQ that provide support and help them define their identity before, during and after the coming out process? Lastly, at the Community Level, what has been done and what is being done to change the homophobic behavior in the Memphis community? What legislation is on the table at the local and state level? What steps are being take on social media to change the homophobic attitude that is still prevalent in our community. The Ecological Perspective Theory is successful in numerous situations as a theory because it does employ the three levels mentioned of intrapersonal, interpersonal and community level. Moreover, researches subscribe to this theory because of its ability to combine different levelts of country (community), family structure (interpersonal) and intrapersonal. Thus making it a sound theory (Perry & Wadsworth 2017). An evidence based program typically can be demonstrated in balance sheets and number of success stories. For the argument of the portfolio, evidence based program will be reliant on the published information of the organization OUTMemphis. The organization offers a to LGBTQ youth Health & Wellness offerings that have grown through donations and community support. From its inception in 2009, the program has added; sexual health, mental health, intimate partner violence, spiritual health and substance abuse (outmemphis.org). Moreover the program has increased in the numbers of community members it can service on a daily basis. PART 4: DIVERSITY AND ETHICAL CONSIDERATIONS The LGTBQ Youth Community in Memphis, Tennessee While all LGBTQ have a history of being subject to mental health issues, the subgroup of transgender youth has had an even tougher road. The term transgender can be defined as a person who is gender incongruent, in other words their gender identities do not match their sex assigned at birth (Anderssen, Sivertsen, Lønning, et al, 2020). As mentioned previously, LGBTQ youth have higher rates of depression and suicidality. Moreover, they also are faced with issues such as risky sexual behavior and drug or alcohol abuse (Rusow, Goldbach, Rhoades, et al 2018). Youth who are transgender face additional situations of being stigmatized and bullied because they do not conform to their assigned birth sex. As a result, they have even more significant rates of isolation, loneliness, victimization and discrimination which in turn leads to higher levels of mental health problems (Weinhardt, Xie, Wesp, et al 2019). A prevention program that would address the specific problems that transgender youth face would include two specific mechanisms. The first mechanism would be teaching the community at large, and the family specifically that the respecting of gender variance with acceptance and flexibility is critical. Moreover, that being cisgender is not the defining characteristic of a person (Weinhardt, Xie, Wesp, et al 2019). The second mechanism is the teaching of educators that children who are trans need support within the educational systems. How teachers should appropriately react to the transgender child and protect them from peers, administrators and the system itself who may not be advocating appropriately (Murray, Pope, & Willis 2017). This in turn would set the example for the children within the classroom and therefore normalize the experience of being transgender. Prevention programs also bring within them ethical considerations that must be dealt with appropriately. One of the first ethical dilemmas that can be brought up is that of informed consent. Prevention programming typically involves large groups, so who does provide the program the consent (Hage, & Romano, 2013)? This issue can be especially sensitive when dealing with youth, and specifically transgender youth when parents may feel that it is not their consent to give depending on the age of the child, even though legally they have the right up until the age of eighteen. A second issue to consider is confidentiality. Confidentiality is a cornerstone of the therapeutic relationship, so how does that factor into a prevention program? Moreover, prevention programs can and do frequently deal with sensitive issues. How to balance intervening with a prevention program for an individual when it would be a breach of confidentiality is an ethical dilemma (Hage, & Romano, 2013)? In the case of a transgender youth, if a counselor knew that a child was having a difficult time in class and the parents were unaware it would be breaking the confidentiality to speak to them. Moreover, there was program within the school for parents of transgender kids to help learn to be an advocate. Therefore, it would be in the best interest of the child speak to them, because they could be engaged in the program and better protect their child. Lastly, stakeholders are critical to the consideration of a prevention program. A stakeholder is a person or organization who has a vested interest in the success of the program. For the transgender youth, those can be parents, educators, LGBTQ organizations, community leaders and legislators. All have reason to make sure that this subgroup is protected from isolation, bullying, victimization and discrimination. PART 5: ADVOCACY The LGTBQ Youth Community in Memphis, Tennessee Advocacy basically can be defined as representing and defending the cause or group for which you stand for. In the case of this portfolio, that would be the LGBTQ youth of Memphis, Tennessee. According to the Multicultural and Social Justice Counseling Competencies (2015), institutional barriers have been defined as social institutions that are in our society such as schools, churches and organizations within the community. This is demonstrated for LGBTQ youth as bullying in schools, being ostracized from churches and being made to feel unwelcome at many organizations within the community. The community realm is defined in the Competencies (2015) as the normative values, and regulations of the society that can be either empowering or harmful and stifling to the growth and development of the group in question. There is evidence presented in this Portfolio that LGBTQ youth is not empowered by society and their ability to grow is stifled by what is concerned “normal”. This is evidenced by the high rates of risky sexual behavior and drug or alcohol abuse and other mental health issues (Rusow, Goldbach, Rhoades, et al 2018). Lastly is the public policy level which is concerned with local, state and federal policies and laws that standardize or effect the development of human growth. In this realm the LGBTQ community as a whole has made great strides with the legalization of same sex marriage, more protection against discrimination, better laws for same sex couples to adopt and spousal rights. While these are all enormous steps, they have yet to really make the necessary impact on the daily lives of LGBTQ youth. This is where the importance of advocacy would step in. Now that the levels have been defined, how best to advocate at each of them? Within institutions advocacy is worked on through a number of different avenues. The first one being antidiscrimination policies that are strictly enforced and specifically created to protect the LGBTQ youth. These are in the schools, churches and community organizations. Secondly, there is LGBTQ training for staff that works to teach them about norms within that community. Lastly, there is the establishment of gay-straight alliances which are a protective factor for the LGBTQ youth and a teaching tool for straight youth (Watson, Varjas, et al 2010). Within the community, the task of addressing the stigma of homosexuality is much more difficult. One tactic is to bring together different groups and essentially create Gay Straight Allianaces within them. Many times people fear what they do not understand, and this is no different with the LGBTQ community. By creating these alliances, the members can then go back to their own part of the world and share their knowledge, therefore lessening the stigma and unknown. Hopefully then paving the way for changing the norms of values of society. The last area is that of public policy. As mentioned above, in this area the LGBTQ community has made great strides. However, more needs to be done as there are many states, especially Tennessee where there are laws on the books that legalize discrimination. As always in a democratic society the best way to change what is unsavory is to change the lawmakers by voting them out of office. For a marginalized group this can mean finding other groups that share their viewpoint and joining forces to create a grassroots effort to back a candidate. Moreover, it can be important for the LGBTQ community to put forth a candidate who is gay, queer, bisexual or transsexual for example to help normalize and remove the stigma. Using the platform of the candidacy as a way of displaying that though they are a member of the LGBTQ community, they are also a member of the community at large. Advocacy is needed at every level, until the community that is being advocated for is fully protected. For the LGBTQ youth, that means safety in schools, churches and community organizations. That moves on to the removal of all stigmas and discriminations that are normative within society and just as importantly through laws. Advocacy cannot end till the rights and freedoms of the marginalized groups are completely protected. References Anderssen, N., Sivertsen, B., Lønning, K. J., & Malterud, K. (2020). Life satisfaction and mental health among transgender students in Norway. BMC Public Health, 20(1), 138 https://cancercontrol.cancer.gov/brp/research/theories_project/theory.pdf https://www.counseling.org/docs/default-source/competencies/multicultural-and-social-justice-counseling-competencies.pdf?sfvrsn=20 Caputi, T. L., Smith, D., & Ayers, J. W. (2017). Suicide Risk Behaviors Among Sexual Minority Adolescents in the United States, 2015. JAMA: Journal of the American Medical Association, 318(23), 2349–2351. https://www.glaad.org/ https://gaycenter.org/programs/mhss/yes.html Hage, S., & Romano, J. L. (2013). Best practices in prevention. In R. K. Conyne & A. M. Horne (Eds.). Prevention practice kit: Action guides for mental health professionals (pp. 32-46). Thousand Oaks, CA: SAGE. Murphy, J., & Hardaway, R. (2017). LGBTQ adolescents of color: Considerations for working with youth and their families. Journal of Gay & Lesbian Mental Health, 21(3), 221–227 Murray, C., Pope, A., & Willis, B. (2017). Sexuality counseling: Theory, research, and practice. Thousand Oaks, CA: Sage Nutt, A.E. (5 C.E., Autumn 2018). Survey finds widespread feelings of fear and rejection among LGBTQ teens. Washington Post, The Perry, J. M., & Wadsworth, S. M. (2017). Work and Family Research and Theory: Review and Analysis From an Ecological Perspective. Journal of Family Theory & Review, 9(2), 219–237. https://www.outmemphis.org/ Rusow, J. A., Goldbach, J. T., Rhoades, H., Bond, D., Lanteigne, A., & Fulginiti, A. (2018). Homelessness, Mental Health and Suicidality Among LGBTQ Youth Accessing Crisis Services. Child Psychiatry & Human Development, 49(4), 643–651 Sue, D. & Sue, D. (2016). Counseling the Culturally Diverse. John Wiley & Sons, Inc. Taylor, J. (2019). Mental Health in LGBTQ Youth: Review of Research and Outcomes. Communique, 48(3), 4–6 Watson, L., Varjas, K., Meyers, J., & Graybill, E. (2010). Gay-Straight Alliance Advisors: Negotiating Multiple Ecological Systems When Advocating for LGBTQ Youth. Journal of LGBT Youth, 7(2), 100–128 Weinhardt, L. S., Xie, H., Wesp, L. M., Murray, J. R., Apchemengich, I., Kioko, D., Weinhardt, C. B., & Cook-Daniels, L. (2019). The Role of Family, Friend, and Significant Other Support in Well-Being Among Transgender and Non-Binary Youth. Journal of GLBT Family Studies, 15(4), 311–325 Winkel, G., Saegert, S., & Evans, G. W. (2009). An ecological perspective on theory, methods, and analysis in environmental psychology: Advances and challenges. Journal of Environmental Psychology, 29(3), 318–328
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COUN 6785: Social Change in Action: Prevention, Consultation, and Advocacy Social Change Portfolio J. Cosme Contents Below are the titles for each section of the Social Change Portfolio. To navigate directly to a particular section, hold down