Assessing Cultural Perspectives and Experiences Relevant to the Treatment of African American Client

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Assessing Cultural Perspectives and Experiences
Relevant to the Treatment of African American
Clients

• Shalonda Kelly, Ph.D.,
• Rutgers, The State University of New Jersey
• Email skelly_at_rci.rutgers.edu
• Presented at the Fourteenth Robert Lee Sutherland
  Seminar, hosted by the
• Hogg Foundation for Mental Health, 2006

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Working with African American Clients Overview
of Presentation

• Important Historical Factors
• Current Realities and Special Concerns
• Strengths and Common Cultural Values
• Culture and the Problem Identification/Treatment
  Process
• Therapists Who Work With African Americans
• Therapists Identity and Privilege
• Therapists Racial Identities
• Discussion of Race and Ethnicity In Treatment
• Strategies For Working With African Americans

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Important Historical Factors

• Traditional African societies and cultures
• Middle passage and slavery
• Jim Crow laws and segregation
• The great migration and integration
• The civil rights movement
• Black immigrants similarities, differences,
  interactions with domestic Blacks

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Current Realities and Special Concerns

• Individual, institutional, and cultural racism
• Physical and mental health disparities
• Socioeconomic factors
• Criminal justice contact
• Microaggressions, invisibility, rage, and healthy
  cultural paranoia
• Grief and loss
• Stereotypes, internalized racism, nihilism
• Multiracial and skin color considerations

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Assessing Strengths Common Cultural Values

• Strengths
• Strong family ties
• Strong community ties
• Religion, spirituality, and the role of the
  church
• Positive racial identity and self concept
• Egalitarian family roles
• Resilience
• Common cultural values
• Expressiveness, nonverbals, language use
• Importance placed on context and experience
• Present focus

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Culture and the Problem Identification/treatment
Process

• Who identifies the problem and how
• Where to go for services
• MH help seeking/first time use of services
• Types of MH services used/Other services used
• Involvement of family in treatment
• Presenting problems/perception of the problem
• Therapists role
• Continued utilization of services

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Assessing Therapist Identity Privilege
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Therapists Racial Identities

• From the foregoing, you may have noticed that we
  all are responded to as a representative of our
  racial group at some point in our lives. It is
  VERY IMPORTANT to be able to use this experience
  to relate to clients that are different from you.
• Consider your thoughts and feelings regarding
  yourselves as racial beings. Think about when
  you first noticed race, how those around you
  discussed it, levels of segregation or
  integration in your history, etc.
• Consider how racial identity develops across
  groups

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The Therapists Role in Working With African
Americans

• Therapists potential stages of development in
  dealing with ethnic differences
• Therapist issues common to Whites
• Therapist issues common to people of color
• Therapist issues common to Blacks
• Empirical data
• Physical/mental health diagnoses and treatment
• Attributions and stereotypes

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Ways to Raise the Issue of Race

• Join with your client first, and foremost
• It is important to ask EACH client how he or she
  identifies culturally, rather than assume certain
  ethnic classifications based upon physical
  appearance or country of origin
• A racial-cultural assessment is particularly
  recommended when
• there appears to be a lack of connection or
  general lack of understanding between therapist
  and the client
• the therapist has strong reactions toward or
  against the client
• conflicts within a couple or family appear to be
  related to cultural values and behaviors
• it becomes clear that either partners statements
  and/or behavior are culturally related
• There is no one correct way to assess
  acculturation, and therapists are encouraged to
  use their own sense of comfort/discomfort in
  addressing this issue

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Assessing Racial Cultural Factors A Checklist
of Important Identities

• Which are important for self/partner?
• Family/Community/Friends
• Religion or Spiritual Beliefs Practices
• Racial Heritage Cultural Activities
• Country of Origin /or Migration Experiences
• Personality Traits/Unique Personal Style
• Job, Finances, or Social Class/Standing
• Personal Values (explain)

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Important Tips for Working with African Americans

• Build a therapeutic alliance and orient them to
  the client-therapist roles, while being sensitive
  to issues of power
• Consider if negative traits are really coping
  responses and adaptive alternative views
• Explore clients feelings regarding
  cross-cultural treatment, role of racism, and
  identity/acculturation
• Include extended families and broader systems
• Do home visits, focus on what they consider to be
  the problem, and accept that racism may play a
  role
• Identify and use strengths, such as religion
• Others???