Next 10 Exits Sessions: Socioemotional Curriculum to Enhance Resiliency to Trauma Volume 4 - Issue 5

Elizabeth Ching*

Department of Occupational Therapy, Samuel Merritt University, USA

Received: July 11, 2023   Published:July 19, 2023

*Corresponding author: Elizabeth Ching, Department of Occupational Therapy, Samuel Merritt University, USA

DOI: 10.32474/OAJCAM.2023.04.000198

Abstract PDF

Abstract

Anxiety and Depression have been exacerbated from the COVID-19 pandemic, especially with young people. Studies have shown one protective factor against trauma is cultural pride. This writer wrote a book entitled, at www.rabbitroar.com “Next 10 Exits: Reflections on Race and Resilience in Vallejo, California.” The author used the study guide for the book to do a 90-minute reading, discussion, and interactive therapeutic arts, i.e. Drawing and Poetry, session to engage participants in reflection on their upbringing as a possible source of resilience. A descriptive study comparing the aggregate scores of pre- and post-tests appear to show there was a slight increase in the mean score of participants having a better understanding of their upbringing upon reflection of the workshop. Using therapeutic arts has been part of the history of the profession of Occupational Therapy. Occupational Therapy practitioners are early adopters of these practices and strategies and will continue to use these tools now and in the future.

Keywords: Transitional Age Youth; Protective Factors; Buffer; Trigger Warning; Social Emotional Curriculum

Introduction

In order to serve a diverse community (American Occupational Therapy Association [AOTA], 2007), occupational therapy as a profession must prepare its workforce to improve “health, well-being, and quality of life for all people, populations, and communities” (AOTA, 2016). Anxiety and Depression have been exacerbated from the COVID-19 pandemic, especially with young people (Kelley et al., [1]). There needs to be a brief socioemotional curricula to address strategies to interrupt and protect from hardship and trauma. Studies have shown one protective factor against trauma is cultural pride. This writer wrote a book entitled, “Next 10 Exits: Reflections on Race and Resilience in Vallejo, California.” The author used the study guide for the book to do a 90-minute reading, discussion, and interactive therapeutic arts, i.e. Drawing and Poetry, session to engage participants in reflection on their upbringing as a possible source of resilience. The question for the study is the following:

Will participants have a better understanding of their upbringing after a “Next 10 Exits” session compared to the start of the session as evidenced by a pre- and post- short online survey? According to the 2010 Census, Vallejo, California has the most racially diverse zip codes in the U.S. As a Third-Generation Korean Chinese American growing up in Vallejo in the 1960s-1980s and identifying as a person of color, the author’s lenses have been shaped by both race and resilience. The now-defunct Mare Island Naval Shipyard brought good paying work to Vallejo during World War II; this was the reason so many different racial and ethnic groups worked and lived in this small city, current population of 122,000. “Strength through Diversity” is on a plaque at the Vallejo Naval and Historical Museum, yet our current society is much more segregated than during the author’s youth. The ten exits in Vallejo are memory markers of the intersections of race and resilience among each of the four racial groups which are almost equally divided to comprise approximately 25% of Vallejo: African American, Asian American/ Pacific Islander, Latinx, and White populations.

Vallejo is a microcosm of the United States because of its racial diversity, what lessons can be learned about how to affect systemic change to structural racism? How can health disparities be reduced and how can there be health equity for all? Through the author’s personal lenses as a Native Vallejoan, health care practitioner and professor, diversity trainer, and artist, the author uses the mediums of trauma and cultural pride to produce the art of healing. Since the book deals with racially diverse youth, protective factors, resilience, familial and cultural pride, and socioemotional curriculum, the literature review will include these topics.

Racially Diverse Youth

Transitional Age Youth (TAY) can be 16-25 years of age and they are more racially and ethnically diverse is the U.S. than ever before (Rivas-Drake & Livas Stein, [2]). Minoritized youth deal with more cultural stressors which are related to poor health and mental health outcomes. Racial/ethnic identity and communalistic values can be protective factors to combat cultural stressors like acculturative stress and discrimination that TAY encounter in their everyday life in the U.S.

Protective Factors

There are several protective factors to use as a buffer to trauma. Physical distancing was a short-term buffer and living in a racially diverse environment was a long term buffer against Anti-Asian bias (Lee & Waters, [3]) during the COVID-19 Pandemic. Over two centuries of historically contextualizing and combating systemic oppression contributed to African American and to Latinx families facing multiple challenges of racism, trauma, and disparities. Using preventative, strength-based models toward health promotion and wellness contribute to healthier individuals and a stronger society (Carlo et al., [4]). Incorporating cultural and spiritual practices even in a limited way during the COVID-19 Pandemic to American Indian and Alaska Native communities improved health outcomes (Kelley et al., [1]).

Resilience

Resilience is not easily categorized. “Resilience is: a) a process, b) a continuum, c) a global concept with specific dimensions” (Khanlou & Wray, [5]). Said another way, individual, family and social environmental factors figure into resilience. That is, the school environment with social emotional curriculum and interactive teaching are ways in which health, social sciences, and humanities can be multiple areas to affect resilience. In summary of describing resilience, resilience can be developed in contrast to being an innate character trait.

Family/Culture

Youth identifying with their family through their mothers’ values in a positive way resulted in a positive youth ethnic identity (Crockett et al., [6]). This research was done mainly with Mexican American youth from the U.S. Midwest along with their mothers. The positive youth ethnic identity served as a protective factor to discourage problematic externalizing behaviors like substance use. Cultural identity formation can vary among ethnic groups. Research with Filipino American and Korean American families and the ethnic-racial socialization influenced the children of the respective groups (Woo et al., [7]). For Filipinos, racial discrimination which was experienced by both parents and youth was positively identified by the youth as being preparation for bias and linked with a stronger ethnic identity. For Koreans, parent-reported discrimination was identified with stronger American identity.

Socioemotional Curriculum

Being rooted to one’s ethnic identity and knowing about stereotypes of one’s racial group can be protective to one’s mental health and build resilience in facing racial discrimination (Atkin & Tran,[8]). The stereotypes of Asians being reserved, diligent, and intellectual are often utilized to not challenge White privilege and works to keep the “bamboo ceiling” in place where Asians are seen as worker bees rather than in positions of leadership and influence. Students and universities would benefit from having required courses that deal with race and stereotypes directly. Developing a social emotional curriculum with interactive teaching can be helpful in the process of cultivating resilience (Kelley et al., [1]). Using the book, “Next 10 Exits: Reflections on Race and Resilience in Vallejo, California” as a springboard to use therapeutic arts like drawing and poetry to interact with individual participants may assist in the resilience continuum [9-12].

Materials and Methods

The initial survey was to gather the responses from an anonymous 6-question pre- and post-test from voluntary participants with a Qualtrics link on the Coalition of Occupational Therapy Advocates for Diversity (COTAD) Book Club online meeting on February 8, 2023. Unfortunately, there were some technical difficulties resulting in low participation. Therefore, there were two additional events utilized to gain participation: 1) The National Conference on Race and Ethnicity in Higher Education (NCORE) Conference Workshop on June 1, 2023; and, 2) The Book Club meeting in the Occupational Therapy Department at a university on June 15, 2023. The surveys state 5 minutes are required to answer questions and write additional optional comments. The instrument has a consent question to publish anonymous responses to the surveys. The surveys also have a “Trigger Warning” to denote that painful memories may arise and to seek one’s own personal support if needed after taking the surveys. The instrument does state that the purpose is to use the data to discuss if participants have a better understanding of their upbringing after attending the Next 10 Exits Session [13,14].

Findings

The anonymous survey was optional and over 30 participants took the surveys. At the time of the close of the surveys on June 21, 2023, there were a total of 30 useable responses of the pre-test and 23 useable responses of the post-test. Qualtrics features were used for data distributions in aggregate as the number of the respondents for the pre-test was higher than the number of respondents for the post-test[15].

As many as 30 participants agreed to participate in the study and completed the demographic questions. The majority of participants (pre-77% to post-80.95%) identified their gender as female. The largest age group was 25-34 (pre-33% to post- 27.27%). The mean score for individuals thinking about how their upbringing shaped them into the people they had become increased (pre-1.0 to post-1.18) Of the 6 questions included in the survey, there were 2 questions which were open-ended. On both the pretest and post-test, participants preferred drawing (52% to 61.90%) to writing poetry (48% to 38.10%) (Figures 1 & 2).

This demographic question was in both pre-test and post-test, and Figure 1 is from the post-test (Table 1).

The mean score for this question increased slightly from pre-test score of 1.0 to post-test score of 1.18 after workshop participation (Figure 3).

Question 6 was the closing question, and the Word Cloud in Figure 3 depicts the common themes from the post-test.

Discussion

The findings of these surveys shows the mean score of the participants did increase after the brief Next 10 Exits Session. Most of the participants identified as female. The majority of the participants were in the 25-34 years age range. Most of the participants named that they had gained something from the workshop.

The following quotes represent takeaway messages from participants of different age groups:

What did you gain if anything from this session?

18 - 24

A new understanding of my hometown’s impact on me as a person

25 - 34

Learning more about others and reflecting on my own identify allowed me to grow personally.

35 - 44

That my values and beliefs are framed around my cultural upbringing and in many ways transcends generations.

45 - 54

Appreciation for range of backgrounds and experiences everyone has

55 – 64

Insights about other participants

65 - 74

More reflection on cultural identity

Implications for Occupational Therapy

This paper explored positive strategies to use to build resiliency to combat Anxiety and Depression. The strategies are not expensive and do not take long periods of time. There were many limitations of this study as the sample size was small, and there were less participants with useable responses in the post-test compared to the pre-test. Nevertheless, this writer plans to use the information generated by the surveys to seek support for using this writer’s book with high school students and young adults to expand their cultural pride as a protective factor against trauma.

The participants from this research group benefit from reflecting on their experience through the use of therapeutic arts which many individuals already utilize in the profession of Occupational Therapy. There is a risk of participants being retraumatized by remembering incidents of their personal histories. The potential benefit of recognizing resilience in the participants and gaining support for the use of therapeutic arts as strategies which may provide protective factors against hardship and trauma will be useful as potential interventions with clients and patients. The benefits outweigh the risks. As occupational therapy practitioners, we are well-positioned to enhance resiliency in all especially young people. This writer intends to encourage the use of our therapeutic tools as a buffer against trauma. We can help uplift those we serve and work towards health equity for all.

Acknowledgment

The author gratefully acknowledges Dr. Arameh Anvarizadeh, Whitney Harris, Dr. Sabina Khan, and Jasmin Torres for their leadership at Coalition for Occupational Therapy Advocates for Diversity (COTAD) for allowing her to be a presenter for the COTAD Book Club. To Dr. Chi-Kwan Shea and Dr. Diane Tom, she thanks them for being so supportive of the book in the Occupational Therapy Department. To Antonio Díaz, Reina Tello, James Tracy, and Antonio Ching Díaz, the author appreciates the assistance at the National Conference on Race and Ethnicity in Higher Education (NCORE) who graciously accepted the proposals for presentations. Finally, she is indebted to Dr. Kay Davis for her helpful consultations on data collection.

References

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