Working With an African-American Population, Research Paper Example

For many years, people have expressed a desire to have a” colorblind society” in which everyone is seen as the same, regardless of differences in gender, sexual orientation, race, culture, and ethnicity.   More recently, it has become clear that this is not the ideal perspective to hold when it comes to our views regarding our fellow citizens.  Instead, what is considered to be the ideal is to acknowledge people’s ethnic, cultural, and racial differences while respecting and valuing them as distinct from each other, but equally valuable..  In particular, healthcare professionals, and  in particular, mental health professionals, have an obligation to view each individual as a person  in a situation, taking into account all of the factors that define who they are.

Monica McGoldrick has been at the forefront of studying the cultural and ethnic differences that need to be understood when working closely with people.  This paper will discuss various issues involved in working with an African-American population, matters that are crucial to consider in order to truly provide the best care possible to our clients.

It is important to understand the history of African Americans in our country because unlike most other immigrant groups, African Americans did not choose to come to United States, but rather, were captured and taken by force to a completely foreign environment.  They were enslaved and treated brutally, and in addition to the horrors involved in being slaves, they were now in a land that was completely alien to them, regarding language, culture, climate, and a variety of other factors that emphasized the extreme need for adjustment to their situations.

McGoldrick discusses the importance of asking African-American patients in therapy exactly where they came from, i.e., their origins—whether they were from Africa, the Caribbean, and exactly what they know about their family history.  The importance of understanding that background helps to empathize with the feelings of loss involved in leaving their family of origins behind, family fragmentation, social dislocation, the difficulty of assimilation, and the anger and frustration that accompanies all of these issues  (McGoldrick et al.,80, 2005.)

Frequently, given their history, African-Americans are reluctant to seek therapy.  There are many factors influencing that hesitation, since in the past, black people seeking therapy were invariably seen as dysfunctional, overmedicated, treated as inpatients rather than outpatients, and were often exposed to therapists who did not believe that African-Americans could benefit from verbal therapy. (Sanchez-Hucles, 2001).

Since the 1970s, there have been reported over-diagnoses of schizophrenia and under-diagnosis of affective disorders among African Americans, when compared with the incidence of these disorders in the general population. (Baker & Bell, 1999).  Researchers have suggested that over-diagnosis of schizophrenia might be connected to therapists’ misunderstanding the hallucinations that are often seen along with the depression experienced by African-Americans.  In addition, clinician bias, it is speculated, may also account for the over-diagnosis of schizophrenia among black patients.  In reality, when unbiased, uniform, structured assessments of patients are administered to black patients, the incidence of schizophrenia is similar to the rates diagnosed in white patients that were admitted to the same inpatient units.

As a result, when clinicians are making assessments of African -American clients, they should carefully examine former diagnoses.  That evaluation should always include evaluating whether or not there is substance abuse involved in the patient’s past, because the hallucinations involved in withdrawing from alcohol are often mistaken for schizophrenic hallucinations.

In order for a therapist to become competent in working with African-American clients, it is imperative that they understand that not all African-Americans are the same, in appearance, religion, values, past history, and all the other factors that distinguish all people from each other.  Although many therapists are reluctant to bring up the issue of race for fear of alienating their clients, they are actually more likely to make a successful connection when the therapist is comfortable asking the clients about their background, their family of origin, including descendants.

According to Sanchez-Hucles, it is vitally important that as with all clients, African-Americans expect and deserve to be treated with respect, such as addressing them as Mr., Mrs., and Ms., instead of calling the person by their first name to start.  It will also increase the chances of a connection being formed if the therapist conveys a genuine attitude of warmth and an interest in coming to know and understand the person or persons.

In addition, the importance of the therapist’s own self-awareness regarding racial bias, discomfort, or even fear is crucial to the establishment of a relationship with an African-American client.  The importance of competent supervision on a regular basis is a vehicle through which therapists can examine their own attitudes regarding differences between people; this will decrease the chance that the therapist’s own prejudices will become an obstacle to the formation of a genuine, warm relationship with an African-American client.  Additionally, therapists need to be comfortable discussing the issue of race with their African American clients, because based on a long history of facing prejudice in many forms, African-Americans can easily discerned peoples’ discomfort in dealing with them if that exists.  Besides supervision, it can be useful for a therapist to take classes,  especially classes that include a variety of ethnicities and cultural differences in students, in order to practice having frank discussions with a range of people about potentially uncomfortable topics regarding race.

References

Baker, F. M., & Bell, C. (2005). Issues in the psychiatric treatment of African -Americans. Cognitive Behavioral Therapy Book Reviews, 1(11), Retrieved from http://www.cognitivetherapyassociation.org/docs/CBTBR-

Vol_1(11).pdf

Boyd -Franklin, N. (2003). Black Families in Therapy (Second Edition): Understanding the African-American. New York: Guilford Press.

McGoldrick, M., Giordano, J., & Garcia-Preto, N. (2005). Ethnicity and family therapy.  New York: The Guilford Press.

Sanchez-Hucles, J. (2001). Staying the course: psychotherapy in the African -American community. Quest, 4(2), Retrieved from http://www.odu.edu/ao/instadv/quest/StayingTheCourse.html