• Patricia Suma, M.S., California Reproductive Health Equity Project Specialist

Addressing the Need for Health Equity Among All Youth


For the last year, I have had the opportunity to lead the development of Health Connected’s newest curriculum, Teen Talk for Youth in Alternative Settings (YAS)—a comprehensive sexual health education curriculum designed specifically for youth who tend to be marginalized by the systems they must engage with, including youth in foster care, youth in juvenile justice facilities, and youth in credit recovery programs. This curriculum has been in the works for quite some time. With a renewed and focused effort prompted by our collaboration with the CA Reproductive Health Equity Project and through a grant from the federal Office of Population Affairs, we have been able to bring the envisioned work to fruition. As we near the completion of the first edition of Teen Talk YAS and a tailored curriculum for Youth in Foster Care, we want to share some reflections from our development process.


I want to acknowledge at the outset that youth in alternative settings are not a monolith. Each young person we encounter in our programs has their own unique lived experiences, thoughts, and perspectives. Statistically speaking, however, young people in these settings share many difficulties, including challenging interactions with the systems in their lives, a lack of consistent support, and a higher rate of complex interpersonal trauma (defined as a child’s exposure to multiple or recurring traumatic events) (Ford, et al., 2013; Wamser-Nanney & Vandenberg, 2013).


We began by first anchoring the development of activities through a trauma-informed lens and incorporating social emotional learning (SEL) into all of the 11 modules included in Teen Talk YAS. To do so, we focused on the neurobiology of trauma, as well as understanding what research says about how the developing adolescent brain responds to traumatic events. We used a framework for trauma-sensitive classrooms that includes approaches to reduce activating or retraumatizing students by regulating the classroom environment (including online classrooms), creating a comfortable space, using calm, inviting, and non-threatening language and voice inflections, teaching social emotional learning (SEL) skills, and creating meaningful relationships with students (Jennings, 2018).


Yet, as valuable as incorporating this trauma-informed lens and informing instructors how an activated student may present in a classroom, there was something missing. The mission of our organization is to equip young people with information, skills, and support to make thoughtful choices about their relationships and sexual health throughout their lives. What was missing from the curriculum was a recognition that not all young people have the same choices and opportunities to make decisions in their lives.


When we speak of well-being, or sustaining and maintaining health, there is an assumption that a person is already in good health—good physical, psychological, emotional, and spiritual health. The truth, however, is that all young people who have been involved with the juvenile justice and/or child welfare systems have encountered some form of trauma, defined as “an event, series of events, or set of circumstances experienced by an individual as physically or emotionally harmful or life threatening, with lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being” (SAMHA, 2019). Such trauma is not just interpersonal, but also includes trauma from structural violence—structural oppression that harms or destroys communities including racism, homophobia, classism, sexism, and poverty (Farmer, 2004).


As Dr. Shawn Ginwright explains in Hope and Healing in Urban Education, structural violence creates a toxic environment and chronic stress that impacts a young person’s “hope, sense of agency, and the ability to see a brighter future” (2016, p. 6). Teaching SEL skills and mindfulness without acknowledging the root causes of stress and suffering for young people who are very aware of these oppressive systems, causes them to internalize their oppression and blame themselves for the “lack of confidence or suboptimal social emotional states” (Ginwright, 2016, p. 8).


Teen Talk YAS incorporates Dr. Ginwright’s (2016) Radical Healing framework, anchoring our conversations of sexual health, communication, relationships, and safety in:

  • culture and healthy identity—celebrating the young people, their culture, and their connectedness

  • creating agency—equipping youth with the tools for them to explore their personal voice and choices and see interpersonal challenges as possibilities

  • nurturing relationships by modeling and scaffolding conversation starters a young person can use in their lives and creating a safe space in our classroom that is free of judgment (including the use of slang)

  • cultivating meaning-making, which requires youth to use their imagination as they think about the world and the type of relationships they see in their lives

  • celebrating their achievement, whether that is coming to class, engaging in conversation, or rescripting an unhealthy interaction.

Acknowledging a young person’s journey and the impact that systems play in their journey is imperative in understanding a young person and having conversations about relationships and sexual health in a safe and authentic manner. Teen Talk YAS aims to equip youth with knowledge and agency to make thoughtful choices about relationships and sexual health by celebrating their identities, achievements, and the knowledge they bring to each session, nurturing relationships with themselves and others, and holding space for them to practice agency.


As much as we want to give young people in these spaces the opportunity to have their questions answered non-judgmentally, attempts to show up to a classroom and answer questions they may have without providing the structure of an intentionally-developed curriculum, places an excessive and unnecessary amount of responsibility on a young person. Youth who have been involved with the juvenile justice and/or child welfare systems have been forced to mature faster than their peers. And yet, they are still young people who may have received partial and misinformation about sexual health and human sexuality. To explore this dichotomy and create a curriculum that is tailored to the lived experiences of youth in foster care, we collaborated with the Youth Advisory Board (YAB) of the National Center for Youth Law. The fantastic YAB members shared their invaluable feedback on Teen Talk YAS through a prototype series we delivered. Their suggestions about the course content and delivery based on this prototype were then included in subsequent versions.


The Teen Talk for Youth in Alternative Settings curriculum creates a shame-free and judgment-free space, where educators can discuss core components of sexual health education—anatomy, identities, consent, communication, relationships, interpersonal violence, STIs, birth control, pregnancy options, and media messages—with young people who are marginalized by many systems. In addition, the Teen Talk YAS curriculum provides opportunities for young people to build skills like mindfulness, grounding, and emotion regulation with the intent of strengthening each young person to create change in their interpersonal relationships and in their community. In this manner, they can see themselves as having agency in their sexual health and relationship choices, as able to foster a community of support and advocacy, and as agents of change and cultivators of hope.



This publication was made possible by Grant Number 1 TP2AH000066-01-00 from the HHS Office of Population Affairs. Contents are solely the responsibility of the authors and do not necessarily represent the official views of the Department of Health and Human Services or the Office of Population Affairs.



References

Farmer, P. (2004). An Anthropology of Structural Violence. Current Anthropology, 45(3), 305- 325.


Ford, J. D., Grasso, D. J., Hawke, J., & Chapman, J. F. (2013). Poly-victimization among juvenile justice-involved youths. Child Abuse and Neglect, 37, 788-800. DOI: 10.1016/j.chiabu.2013.01.005


Ginwright, S. (2016). Hope and Healing in Urban Education: How Urban Activists and Teachers are Reclaiming Matters of the Heart. New York: Routledge


Jennings, P. A. (2018). The trauma-sensitive classroom: Building resilience with compassionate teaching. New York: W.W. Norton & Company


Substance Abuse and Mental Health Services Administration (SAMHSA). (2019). Trauma and violence. Retrieved from www.samhsa.gov/trauma-violence


Wamser-Nanney, R., & Vandenberg, B.R. (2013). Empirical Support for the Definition of a Complex Trauma Event in Children and Adolescents. Journal of Traumatic Stress 26 (6), 671-678. DOI:10.1002/jts.21857



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