(PS3-D83) A Qualitative Study of Perspectives of Black Adolescents on Social Anxiety Symptoms and Barriers to Treatment Engagement in School-based Interventions

Social anxiety (SA) is among the most common challenges in adolescents, with 29.5% of youth reporting elevated clinical symptoms (Hawes et al., 2021). However, there have been virtually no studies examining SA in Black adolescents, which is problematic as SA is associated with greater school drop-out rates, poorer social performance, and negative evaluation from peers (Stein & Klein, 2000; Spence & Rapee, 2016). This study aims to understand the cultural experiences of Black students to assess cultural factors related to social anxiety and specific barriers to seeking mental health treatment. Information gathered will aid in developing and implementing a culturally sensitive school-based group intervention that targets SA in Black students. Seven Black students enrolled in an urban high school in New Jersey were recommended by school personnel based on their elevated “shyness” to participate in the study. Students participated in individual semi-structured interviews conducted by the research team in person. Each interview asked students about their views of SA, barriers to school-based interventions in their communities, and cultural views of SA or general mental health services. For example, questions included “What types of things do Black students face that are different from other students' faces?” and “Do you feel that a group program designed to support very shy or nervous teens would be helpful?” A qualitative thematic analysis was conducted to identify core themes highly prevalent among students' transcriptions, such as “Negative Experiences related to SA.” Particular details were also assigned as subcodes for themes, such as “Racism” as a subcode for “Negative Experiences related to SA.” Findings indicated that students' experiences of racism (e.g., stereotyped as “ghetto” by peers) and cultural norms in the Black community (e.g., expectations of only disclosing SA concerns within the family) are associated with SA symptoms. Regarding barriers to seeking school-based services, students commonly reported fears of stigma or judgment for seeking help (e.g., perceived as “weird” by peers). Additionally, all but one student stated challenges associated with adults’ attitudes to help-seeking or SA, such as parental lack of understanding of the severity of their child’s concern. Moreover, all students indicated preferences on school or general therapist characteristics that they would be comfortable discussing their mental health and continuing treatment with. There were mixed findings reflecting variability within individual preferences, as some students prefer a therapist of the same race or gender, while others do not have this preference. Overall, these findings highlight the need to tailor interventions. Specifically, practitioners must challenge stereotypes of help-seeking and teach students techniques that address racist messages and promote racial empowerment. Students should also be individually assessed for their therapist preferences which can help them build stronger alliances with therapists and thus more effectively engage in treatment.