Running head: LITERATURE REVIEW AND SOAP NOTE

Literature Review and Soap Note: Julie

Mary Winford

Wake Forest University

 
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Julie is a 30-year-old African American woman who discussed how her upbringing and

journey through school impacted her identity and self-esteem. She feels her experiences have

helped her grow in understanding her cultural identity, but she still needs help understanding her

cultural identity and struggles with self-esteem from being constantly put down by her father and

others. She hated the black parts of herself and is now finally starting to love herself, but needs

help overcoming her insecurities. She has also dealt with adversity and racism among her peers.

Research suggests that CBT is helpful in increasing self-esteem and helping with identity

development. Low self-esteem means to have a negative view of yourself. Julie mentioned her

hair being a problem and originally assuming that it was difficult to make friends with other

races because of her looks and not because they were prejudice. It is suggested that low self-

esteem often comes from early, negative life experiences (Morton, Roach, Reid, Steward, &

Hallam, 2012). Racial Identity and self-esteem are strongly correlated with each other which

could also explain why those are both Julie’s main issues. Research suggests that for African

Americans, identity development and self-esteem are connected to racial preferences and racial

identity. It is difficult to differentiate the feelings one feelings about themselves and the feelings

about their racial group. African Americans with low self-esteem are more likely to have mental

health problems. Those with high self-esteem are quicker to recover when facing adversity

compared to those with low self-esteem. An increase in racial identity development over 1 year

was associated with a decrease in depressive symptoms even if self-esteem was controlled. Self-

esteem is considered one of the most important factors in an adolescent’s mental health and

research is suggesting that identity may be just as important. Therefore, it could have been really

harmful to Julie’s mental health when she was receiving hurtful comments while in school. She
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also had trouble accepting her cultural identity and was shameful of it which could also be

harmful to her mental health.

Racial identity is multidimensional and includes: an understanding and acceptance of

one’s socially constructed racial label, a sense of shared activities, beliefs about the social

construction of one’s racial group. (Mandara, Gaylord-Harden, Richards, & Ragsdale, 2009).

According to the multidimensional model of racial identity, racial identity is a part of an

individual’s self-concepts connected to their membership within a race. It consists of the

significance that the individuals’ place on race when defining themselves and interpreting what it

means to be African American (Nevlett, Smalls, Ford, Nguyen, & Sellers, 2009).

Knowledge of one’s racial group history and cultural norms, beliefs about the social position of

one’s racial group, and feelings of pride about one’s racial group. In the perspective of cognitive

development, racial identity is developed when the person is able to cognitively make sense of

the many social messages about race that they face. Messages about race are generally socialized

by the parents, teachers, media, and peers. This can explain why her grandfather’s negative

comments about the black people in her neighborhood affected her. The media seemed to have

an impact on Julies views as well. Ecological systems theory suggests that normal development

for African American adolescents often involves exposure to environments that devalue their

racial group. Exposure to these types of environments can be damaging to the self-esteem and

mental health of African American adolescents. Developing a positive view of one’s racial group

can be a protective adaptive coping response against those types of environments and protects

against the psychosocial consequences of discrimination. Media exposure is really high among

African Americans and many African Americans are exposed to media that is high in negative

stereotypical portrayals. Often, if society views a group negatively than the members of that may
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also view themselves negatively though, having a positive racial identity prevents an individual

from caring about the media’s portrayals. A research study showed that Multigroup ethic identity

measure was positively correlated with their level of coping and that support of stereotypical

beliefs about African Americans was positively correlated lower self-esteem among African

Americans in high school. A study found the development of positive feelings about one’s racial

group is related to reducing mental health problems. Theorists have suggested that racial identity

has an association with mental health because it may be helpful to African Americans with the

avoidance of internalizing negative stereotypes. It may also offer protection against the effects of

discrimination. A positive racial identity may help African Americans feel that the practices of

discrimination are not a result of group deficiency (Mandara, et al, 2009).

Adolescence is often the developmental period of when the negotiation of racial identity

becomes a focus. It is during this time period that physical maturation, dating experiences, and

increased autonomy cause one to experience many new situations and experiences that may

increase the notability of race. This may cause adolescents to think about the importance and

meaning of race. This increased awareness makes it possible for African Americans to actively

look into the meaning and significance of being African American. One of the most significant

social contexts that plays an important role in how African Americans make sense of the

importance and meaning of race is the African American family. Both the explicit and implicit

messages about race, help African Americans to develop a positive racial identity. Especially

when facing adversity or racial bias. Racial socialization is defined as transmitting the world

views of parents in regard to race and ethnicity in either an unintended, overt, deliberate, or

subtle way. It can be a way to promote positive racial identity and prepare children to strive

against racism. Some parents may consider race to be an important factor in raising their
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children. It may be the central factor in how their children are raised, some may only discuss

racial issues when they are brought up by their children, but there are some parents that may

completely play down the importance of race.

There are many messages portrayed in racial socialization; self-worth message promote

individual feelings of worth, negative messages increases negative stereotypes from society

about African Americans, and egalitarian messages place importance on coexistence and

interracial equality. Some studies discuss socialization behaviors such as buying African art or

literature which conveys implicit messages about race. When understanding racial identity, it is

important to look at an individual’ racial regard which is an individual’s evaluative judgement of

their race. Private regard is the extent an individual feel positively or negatively about their race

and race membership. Public’s regard is the extent an individual feels other view their race as

positively or negatively. Lastly, racial ideology is a collection of an individual’s opinions,

beliefs, attitudes about how African Americans should act. Some may have a nationalist ideology

which places importance on the uniqueness of being black, some may have a oppressed minority

ideology which focuses on the similarities of African Americans and other oppressed groups,

some may have an assimilation ideology that focuses on the similarities of African Americans

and the rest of Americans, and some may have a humanist philosophy that places importance on

the commonalities of all human beings (Nevlett et al, 2009).

Some of the most important approaches to understanding ethnic and racial identity

focuses on how African Americans develop attitudes and beliefs about their racial or ethnic

identity. Some theory suggests than an individual’s identity can be viewed by looking at statuses

such as: a diffused status where the individual have not explored the meaning of their ethnicity or

committed to a particular identity meaning, a foreclosures status where the individuals have
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committed to a definition of their ethnicity means to them related to how others have influenced

them such as their parents, a moratorium stays where the individuals are actively exploring the

meaning of their identities and have not committed to a particular meaning, and achieved status

which are individuals who have actively explored and committed to a specific definition (Yip,

Seaton, & Sellers, 2006)

Many African Americans will face racial discrimination and some ways of coping with

adversity would be using resistance and advocacy. Resistance is when an individual confronts

the perpetrators of discrimination while coping by advocation and educating others and oneself

in order to increase the awareness of discrimination for oneself and other people. It can fight

discrimination at both micro and macro levels (Szymanski & Lewis, 2015).
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References:

Mandara, J., Gaylord‐Harden, N. K., Richards, M. H., & Ragsdale, B. L. (2009). The Effects of

Changes in Racial Identity and Self‐Esteem on Changes in African American

Adolescents’ Mental Health. Child Development, 80(6), 1660–1675. Doi:10.1111/j.1467-

8624.2009.01360.x

Morton, L., Roach, L., Reid, H., & Stewart, S. H. (2012). An evaluation of a CBT group for

women with low self-esteem. Behavioural and Cognitive Psychotherapy, 40(2), 221-5.

Doi:http://dx.doi.org.go.libproxy.wakehealth.edu/10.1017/S1352465811000294

Neblett, E.W., Smalls, C.P., Ford, K.R. et al. Racial Socialization and Racial Identity: African

American Parents’ Messages About Race as Precursors to Identity. J Youth Adolescence

38, 189–203 (2009). https://doi-org.go.libproxy.wakehealth.edu/10.1007/s10964-008-

9359-7

Szymanski, D. M., & Lewis, J. A. (2016). Gendered Racism, Coping, Identity Centrality, and

African American College Women’s Psychological Distress. Psychology of Women

Quarterly, 40(2), 229–243. https://doi.org/10.1177/0361684315616113

Yip, T., Seaton, E. K., & Sellers, R. M. (2006). African American Racial Identity Across the

Lifespan: Identity Status, Identity Content, and Depressive Symptoms. Child

Development, 77(5), 1504–1517. Doi:10.1111/j.1467-8624.2006.00950.x

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Soap Note

2/27/2020. 5 pm. (S) Describes herself as a African American female. States that race has

impacted how she views the world since the day she was born. She was raised in a single-parent

African American household. She lived with her maternal grandfather who acted as a surrogate

father. She reports feeling that her real father is very distant, constantly putting her down. She

reports that her mother’s excuses for her father’s negative comments were worse than the

negative comments. She reports that her earliest dreams of being a career woman were colored

how she thought white people did things. She reports being teased about her hair and asking her

mother why her dad couldn’t have been so she could have good hair. She reports that her father

wasn’t faithful to her mother which made her wonder if only white families had faithful

husbands, and if it was her fate to raise her children alone and bear them outside of marriage. She

questioned why she is not considered beautiful. She shared that she tried to sound white and

wanted to be anything but black. She reports identifying with the white culture and hating

everything about being black. She reports that making friends with other people who were not

black was harder when she got to college. She reports that white males taunted her, calling her

the n word. She reports that her roommate’s boyfriend made racial comments and the women on

the floor were awful making comments about her hair. She reports that her English teacher said

she considered going into public speaking because she cannot write and that her people were not

known for their writing ability. She reports that her breaking point was when her dorm believed

she was in on the robbery that happened in their dorm because she was black. She reports she

then hated whites and participated in more African American Activities. She reports successfully

getting more blacks to join the dorm and beginning to see the dorm as a great place. She reports

being a changed woman after college and became open to a multicultural world, being confident
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in who she was as a Black woman. She reports feeling hurt and angry and determined not to let

whites get close to her. (O) 30 years old. African American female with curly black hair. Has a

slight valley girl/British accent. Is quiet when discussing her identification with white culture and

when discussing hurtful comments from others. Gets louder when talking about how she started

enjoying her time at the dorm and when discussing feeling more connected to her culture.

Displays confidence when talking about identifying with American culture. (A) Dominant story

involves achieving an understanding of one's identity, understanding racism and oppression, and

letting the perceptions of others determine how she sees herself. She goes through a journey of

self-discovery while encountering many difficult situations involving racism, oppression, and

self-oppression. She began to mistrust white people, but a white coworker helped her grow and

start to develop. (P) Intervention used in 1st session: Cognitive behavioral therapy. Emphasis on

cultural identity development and self love in order to negate insecurities and build self-esteem.

Discuss how her experiences have an impact on her identity development.