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Working Effectively with African American Patients A Seminar about African American Mental Health Is

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Title: Working Effectively with African American Patients A Seminar about African American Mental Health Is


1
Working Effectively with African American
PatientsA Seminar about African American Mental
Health IssuesWilliam H. Anderson, Jr.February
8, 2004
2
African Americans
  • 33.9 million people (12 of Population)
  • Includes African immigrants Individuals from
    Caribbean Countries
  • 53 live in the South
  • 37 live in the Northeast and Midwest
  • 10 live in the Western United States

3
The Scope of this Seminar
  • 1) Socio-cultural characteristics affecting
    mental health services
  • 2)Attitudes toward mental health services
  • 3)Some common problems facing therapists treating
    African Americans
  • 4)Therapeutic approaches and issues related to
    process, outcome, and patient satisfaction

4
A Working Framework vs. Stereotypes
  • 1)These issues should not be rigidly viewed as
    applying to all African Americans
  • 2) Throughout our discussion we should be
    cognizant of individual differences that do not
    conform to any stereotype

5
Premises
  • African American culture is distinct yet shares
    similarities with other cultures
  • There is considerable cultural diversity among
    African Americans
  • Class does not trump race
  • Both the popular media and the scientific
    literature have emphasized black dysfunction
    deficits more than strengths
  • Empowerment must become a central part of any
    treatment plan
  • Adopt from Nancy Boyd-Franklin (1989)
  • Black Families in Therapy a multisystems
    approach.
  • New York Guilford

6
Hills Five Positive Characteristics
  • 1) Adaptability of family roles
  • 2) Strong kinship bonds
  • 3) Strong work orientation
  • 4) Strong achievement orientation
  • 5) Strong religious orientation
  • Hill (1972) The Strengths of Black Families
    A National Urban League Research Study New
    York Emmerson 6 Hall

7
Dimensions of Black Subsocieties
  • Social Class
  • Rural or Urban Residence
  • Region of Origin and Domicile
  • Billingsley, A. (1968) Black Families in
    White America
  • New Jersey Prentice-Hall

8
  • Education does not always provide upward mobility
    for African Americans in the same way that it
    does for the majority population

9
  • Among the multiple causes of economic
    disadvantage, there remain racist policies and
    attitudes that hold African Americans down

10
  • Economics, political and social forces of the
    larger society strongly affect the conditions
    determining the life styles of African Americans

11
Social Class Life Styles
  • Upper Class
  • Upper middle class
  • Solid middle class
  • Precarious middle class
  • Working non poor
  • Working poor
  • Non working poor
  • Billingsley (1968)

12
The Black Upper Class
  • Heads of household are highly educated
  • Very high income levels
  • Secure occupations in which advancement is
    possible
  • Comfortable housing

13
The Black Middle Class
  • Upper middle class
  • Solid middle class
  • Precarious middle class

14
The Black Lower Classes
  • Working non poor
  • Working poor
  • Non working poor

15
Working Non Poor
  • Semiskilled workers
  • Stable and secure job niche

16
Working Poor
  • Unskilled service occupations
  • Marginal incomes
  • Often have to hold down multiple jobs in
    attempting to make ends meet

17
Non Working Poor
  • Unemployed or intermittently employed
  • Supported by relatives and friends
  • Often on public assistance
  • Sometimes in prison

18
Attitudes of American Society and Mental Health
Professionals
19
Identity, Self-esteem Skin Color
  • Any area as toxic as this one is fertile ground
    for the development of family myths and secrets.
    This is compounded by the fact that these issues
    are rarely discussed openly in many Black
    families. Given the many family secrets about
    birth, paternity, and informal adoption, a child
    who looks very different from the rest of his
    family or household members may have a very
    difficult time while growing up. Children may be
    favored or rejected because of lighter skin
    color. A child may be scapegoated as the darkest
    member of the family or favored because he
    resembles an ancestor. (Boyd-Franklin, 1989)

20
The Role of Community Networks
  • Relatives
  • Non-relatives
  • Pastors
  • Teachers
  • Other responsible adults role models
  • Professional Helpers

21
Cultural Factors vs. Resistance
  • Stepping out of the expert role
  • Listening and Learning
  • Communication styles
  • Common experiences
  • Unique needs

22
The Bottom Line
  • In addition to getting as much training and
    knowledge as possible regarding the patients
    ethnicity, strive for sensitivity, and work to
    establish a trusting patient-therapist
    relationship.
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