Following the outline on The Stigma tied to African Americans seeking counselling services, write a research paper.
Understanding how race and culture in contemporary counselling play a significant role in the success or failure of methods used is crucial in examining a multicultural and multiracial society. A comprehensive understanding of how a specific society functions and the different issues affecting each community necessitates different approaches towards diversity through understanding how each culture works and the challenges each group faces. In the African-American community, there has been a rising trend in the presence of psychotic symptoms in African Americans since the 1970s; arguably, its advancement is due to specific barriers brought about by the recognition and treatment of depression (Baker, 2001; Das et al., 2006). This study will explore the stigma associated with counselling and the barriers that interfere with viable treatment; consequently, the research will also examine how the awareness role created by the community and religion can benefit depression and mental health patients.
According to Das et al. (2006), the obstacles affiliated with diagnosing and treating depression-based disorders prevalent in the African American population include underdiagnosis, somatization diagnosis, other competing clinical demands, and diagnosis stigmatization. While all the other factors deal with physician, patient, and treatment setting factors, diagnosis stigmatization deals with a societal outlook. This study aims to delve into the cultural impact of counselling through community interaction.
According to research by Cook et al. (2017), there is an increased risk of trauma and cumulative impairment of a child’s mental health, including chronic mental illness, legal and family problems, and addictive and psychiatric disorders, when exposed to traumatic experiences or maltreatment. Additionally, most African Americans grow up in neighbourhoods where they are regularly exposed to recurring substance abuse, community violence, and physical and emotional abuse, among other environmental stressors (Alicea et al., 2012). For this reason, African Americans experience significantly higher anxiety rates and are more depressed than their European American counterparts (Williams, 2012). Conclusively, the environment a person is brought up in is one of the dominant factors in the mental health of the individual in the later stages of their life.
Additionally, studies have shown that living in such a neighbourhood has a delirious effect on memory and cognition and causes post-traumatic stress disorders associated with aggressive behaviours and delinquency among young people (Shakoor & Chalmers, 1991). For this reason, children and young adults regularly exposed to family violence and complex trauma often fit the criteria outlined in the Diagnostic and Statistical Manual for Mental Disorders, resulting in relational impairments (Cook et al., 2017). Arguably, experiencing crime in these children leads to co-victimization, which means that they directly observe the criminal acts, which may have a profound impact on their lives (Shakoor & Chalmers, 1991). Consequently, this leads to conflict with a combined attitude, negative statements, and frustration; arguably, once the trend begins, the cycle of violence experienced by these individuals provides stimulation and arousal that defines the character and self-identity of the person (Shakoor & Chalmers, 1991). Although it is not perceivable when this trend begins, it results in a high correlation between observation of aggression and violence, and the individual initiates and adopts hostility as a coping mechanism. It is observable that living in an environment that experiences constant violent behaviour can not only cause depression but also lead to adverse mental degradation and continued violence by children who grow to adulthood; this is nowhere more prevalent than in African-American neighbourhoods.
Finally, a growing number of researchers have identified segregation and racism as contributing factors to increased mental cases of blacks in America. For this study, the term racism is used to denote an organized system that leads to the suppression or alienation of one group of people in preference to others; this definition recognizes that racism can exist at an institutional level while being absent at an individual level in any given society. Firstly, there is enough data to conclude that with the decline of racism, there was a perceivable increase in mental health (Williams & Williams-Morris, 2000).
Secondly, racism within the American society has affected policy-making in institutions, employability, and perceivable segregation in housing choices; arguably, this leads to truncated socioeconomic mobility, resulting in differential resources access and forcing African Americans to live in adverse conditions, thereby affecting their mental health (Williams & Williams-Morris, 2000).
Additionally, racist experiences can induce psychological and physiological reactions that harm the person’s health. Finally, in today’s society, where ethnic differences are a self-identifying, racial-conscious culture, acceptance of harmful stereotypes leads to self-evaluations which may hurt the person’s psychological well-being (Williams & Williams-Morris, 2000). Racism in America has been institutionalized, and the impact of alienating African Americans has adverse consequences on a person’s health. The three most significant influences on the increased need for counselling affiliated with the environment include effects on the backgrounds on a person’s psychological makeup, the impact of repeated violence in society, and perception, categorization, and ranking of blacks as inferior to others; all these have been shown to affect a person’s mental health.
Most studies tackling mental health degradation’s effect on a person follow an individualistic psychological paradigm; however, socioeconomic factors also play a massive role in investigating and broadening the understanding of the stigmatization of mentally ill individuals in a community amongst African Americans. The stigmatization may be systematic, whereby the institutional and structural intentionally restrict services and opportunities towards the mentally sick and depresses people; additionally, it also includes policies that are not meant to discriminate, but their consequences hamper options available towards people with mental health conditions. African Americans often suffer from the latter.
One of the discriminatory consequences is the increase of health-related insurance policies for people living in unsafe neighbourhoods. According to Williams & Williams-Morris, (2000), the perception of blacks being inferior has permeated into institutions such as insurance; arguably, this has translated to policies targeting them.
Additionally, although health has improved over the years, there has been little done to eliminate ethnic or racial disparities; arguably, the variations are much more prevalent in decreased health care, societal concerns, patient care, provider issues and slow health care system delivery (Groman & Ginsburg, 2004). The reasoning behind this discrepancy lies in lower income, a high chance of being underinsured, less education, and a high dependency on public health programs (Aston et al., 2003). Additionally, the stigma associated with psychological disorders is viewed by society as dangerous, which leads to the condition worsening.
African- American uses several strategies to deal with mental-related health issues and the need for counselling. One of the ways to deal with these problems is escapism through religion and prayers. According to a survey, more than 85% of African Americans regard themselves as very religious; additionally, 78 % reported praying daily (Snowden, 2001). Many blacks identify God as a foundation for their beliefs and coping mechanisms during their most difficult times.
Consequently, because of the effect these religious experiences have on the population, it is prudent to examine and increase the knowledge on the impact it has on mental health as well as professional counselling; this will enable the study to find if there is any benefit accrued from such an experience. Arguably, because of the black culture’s salience of religion and spiritualism, they are used by most African Americans rather than seeking help from a professional mental health practitioner (Avent & Cashwell, 2015). For this reason, for a professional to effectively undertake healing sessions with African-American members, they should get a basic understanding of the black church’s effect on the patient’s life.
To understand why the church forms an epicentre for dealing with their problems, a look at the history that makes up the church is essential. The black church foundation was to act as a liberty symbol where blacks got a sense of freedom away from the oppressive plantations and the segregation of white men; it was later to involve itself in civil rights movements that changed the course of black lives in the 20th century (Byrd, 2001). In the black church, African Americans could express their authentic selves; this includes healing and improving physical and psychological health. (McBeth, 1981; Joubert, 2010). The black church’s theological outlook is based on deferred freedom and reward to the afterlife or what they refer to as “the other world.” Their message is always a reminder that earthly suffering is temporary, all tears will be wiped away, and they will suffer no more (Cashwell & Young, 2011).
Consequently, these teachings make most of the congregation less likely to explore counselling to treat their mental illnesses. They are less oriented to face their problems and concentrate more on the promises to be reaped after they die. Some other black churches teach that the rewards are of “this world,” this means that the congregation gets to enjoy earthly happiness and freedom rather than a promise that will one day come when we die. In such a case, members of such a church are more likely to seek avenues to lessen the pain so that they can enjoy the things of this world more; therefore, these beliefs manifest in an individual in the form of seeking psychological health, this results in an open attitude towards counselling.
According to Kuczewski (2007), helping professionals are mandated to assist vulnerable people in facing painful choices and challenging situations; therefore, it is prudent for any professional not to blush aside the spiritual and life experiences of such individuals while undertaking to counsel. Black church ideologies have an enormous impact on African-American lives, and even though it has presented problems in the ability of the practitioners to treat mentally ill patients, the effect of faith practised by the adherents can serve a pivotal role, if used correctly, in aiding the counselling session to be more effective.
As discussed above, the African American society used the black church as a de facto social service to meet their social justice, financial and mental health needs; arguably, this led to a close-knit society that relied on each other to survive the hard realities of life. This understanding and sensitivity have eluded most professional counsellors making it hard to reach out and help these communities. In a study by Thomas et al. (2002), 143 females and 66 males over 18 conceded were asked about the most significant challenge facing the effectiveness of a non-black psychotherapist when handling a black client. The report concluded that the participant’s race did not matter, but they felt that the psychologists lacked cultural understanding and sensitivity toward the African-American (Thomas et al., 2002).
Therefore, African-American therapists must make a meaningful cultural connection and aid in finding a solution to their problems. One of the issues pointed out by the participants was that getting an African-American psychologist was hard (Thomas et al., 2002). There is, therefore, a need to increase the number of black therapists for meaningful progress to be experienced in treating African-American patients
In the study by Hardy (2014), the researcher analyzed professional preference by the type of issues faced by the respondents. The data revealed that church members were more likely to seek help from a pastor if the problem involved a traditional area of expertise like marriage (Hardy, 2014). On the other hand, licensed counsellors were preferred in discussing finances, anger/temper, attempted suicide, contemplating suicide, homosexuality/sexuality, and drug abuse. The data also found that age and socioeconomic differences impact a person’s choice of counselling, with elder people preferring pastors’ intervention on almost all issues.
Substantial evidence supports that a person’s religious life is critical to an individual’s personal growth and overall well-being (Cashwell & Young, 2011). Additionally, researchers have found a correlation between improved physiological health and the positive incorporation of faith and spiritualism in a person’s life (Matthews et al., 1998). For this reason, in treatment, a person’s spiritual faith and counselling should go hand in hand. Counsellors should understand that the ideology that guides most black churches is that it always takes care of their own; this may include mental health problems and specific programs aimed at teaching life skills to deal with stress-related lifestyles. In this case, members may feel there is no need to seek outside help.
One way of reaching out to such a congregation is through offering a voluntary outreach service rather than depending on the members to initiate communication. Consequently, the counsellor will advocate change for their members through programs that have worked in the past through the distribution of clothing, mentoring, tutoring, and non-religious educational services (Sue & Sue, 2013; Tsitsos, 2003). Another way would be using local pastors to bridge the gap between the counsellor and the church members; these pastors highly influence African-American communities and black churches (Mattis et al., 2007). The role of these pastors often extends beyond religious functions, and the congregations are more likely to seek counselling from a counsellor recommended by them. Additionally, the latter will have the opportunity to learn the methods that the former use in responding to mental-related health issues and adjust their program to accommodate the client’s religious beliefs.
The ties between the community and mental health have been found to improve a patient’s psychological well-being. The public stigma associated with psychological disorders robs the patients of the dignity they deserve and opportunities in the job market; additionally, alienating such individuals is worse than the condition itself (Thornicroft, 2016). According to the study, one way to reduce stigma is the community’s involvement through social contact in the short term; in the long run, a concentrated effort into viable anti-stigma groups and programs has shown considerable success (Thornicroft, 2016). Additionally, promoting positive social contact was found to be beneficial in predicting awareness programs at the community level (Evans-Lacko, 2012). In conclusion, for the stigmatization affiliated with psychological disorders to be removed, the community must be actively involved in group-oriented programs.
Several environmental issues were identified in researching factors that affect the black community in America. A conclusion was drawn that reducing violence in this neighbourhood was the biggest hurdle towards decreasing the need for counselling. Next, support through the community was explored with the effect of black church involvement clearly shown, and the lack of understanding and empathy in non-black psychologists examined. Substantial gains will occur when the various steps outlined in the study showing how to avoid these barriers are followed.
Ashton, C. M., Haidet, P., Paterniti, D. A., Collins, T. C., Gordon, H. S., O’Malley, K., … & Street Jr, R. L. (2003). Racial and ethnic disparities in the use of health services: bias, preferences, or poor communication? Journal of General Internal Medicine, 18(2), 146-152.
Avent, J. R., & Cashwell, C. S. (2015). The Black church: Theology and implications for counselling African Americans. The Professional Counselor, 5(1), 81-90.
Baker, F. M. (2001). Diagnosing depression in African Americans. Community Mental Health Journal, 37(1), 31-38.
Byrd, A. D. (2001). Adult educational efforts of the American Black Church, 1600–1900. Journal of Religious Thought, 44, 83–93.
Cashwell, C. S., & Young, J. S. (Eds.). (2011). Integrating spirituality and religion into counselling: a guide to competent practice. Alexandria, VA: American Counseling Association
Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Cloitre, M., … & Mallah, K. (2017). Complex trauma in children and adolescents. Psychiatric Annals, 35(5), 390-398.
Das, A. K., Olfson, M., McCurtis, H. L., & Weissman, M. M. (2006). Depression in African Americans: breaking barriers to detection and treatment. The Journal of Family Practice
Evans-Lacko, S., London, J., Japhet, S., Rüsch, N., Flach, C., Corker, E., … & Thornicroft, G. (2012). Mass social contact interventions affect mental health-related stigma and intended discrimination. BMC Public Health, 12(1), 489
Groman, R., & Ginsburg, J. (2004). Racial and ethnic disparities in health care amongst the African Americans: a position paper of the American College of Physicians. Annals of Internal Medicine, 141(3), 226.
Joubert, N. (2010). How Christianity spirituality spurs mental health. In J. H. Ellens (Ed.), The healing power of spirituality: vol. 3. Psychodynamics. Santa Barbara, CA: Praeger
Mattis, J. S., Mitchell, N., Zapata, A., Grayman, N. A., Taylor, R. J., Chatters, L. M., & Neighbors, H. W. (2007). Use of ministerial support by African Americans: A focus group study. American Journal of Orthopsychiatry, 77, 249–258. doi:10.1037/0002-94126.96.36.199
Matthews, D. A., McCullough, M. E., Larson, D. B., Koenig, H. G., Swyers, J. P., & Milano, M. G. (1998). Religious commitment and health status: A review of the research and implications for family medicine. Archives of Family Medicine, 7, 118–124.
McBeth, L. (1981). Images of the Black church in America. Baptist History and Heritage, 16(3), 19-28.
Shakoor, B., & Chalmers, D. (1991). Covictimization of African-American children who witness violence and the theoretical implications of its effects on their cognitive, emotional, and behavioural development. Journal of the National Medical Association, 83(3), 233-238.
Snowden, L. R. (2001). Barriers to effective mental health services for African Americans. Mental Health Services Research, 3(4), 181-187.
Sue, D. W. & Sue, D. (2013). Counselling the culturally diverse: Theory and practice (6th ed.). Hoboken, NJ: Wiley & Sons.
Thompson, V. L. S., Bazile, A., & Akbar, M. (2004). African Americans’ perceptions of psychotherapy and psychotherapists. Professional Psychology: Research and practice, 35(1), 19.
Thornicroft, G., Mehta, N., Clement, S., Evans-Lacko, S., Doherty, M., Rose, D., … & Henderson, C. (2016). Evidence for effective interventions to reduce mental-health-related stigma and discrimination in African American Communities. The Lancet, 387(10023), 1123-1132.
Tsitsos, W. (2003). Race differences in congregational social service activity. Journal for the Scientific Study of Religion, 42, 205–215. doi:10.1111/1468-5906.00173
Williams, D., & Williams-Morris, R. (2000). Racism and mental health: The African American experience. Ethnicity and Health, 5(3-4), 243-268.
Williams, M. T., Chapman, L. K., Wong, J., & Turkheimer, E. (2012). The role of ethnic identity in symptoms of anxiety and depression in African Americans. Psychiatry Research, 199(1), 31-36.
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Published On: 14-03-2018