Personal Perspectives on Counseling and Psychotherapy with African Americans

Any appropriate treatment model focusing on the African American family will need to incorporate aspects of culture thought to be basic to the adaptive functioning of the family. It is hypothesized that the premise upon which family counseling is built, as they pertain to African American families, may be faulty (McAdoo, 1977). The many cultural dimensions of African American families are usually not fully considered when the family is engaged in counseling. Any appropriate family treatment model should clarify and demonstrate some understanding of values and behaviors considered essential to the understanding of behavioral dynamics found within the family and the total experience considered. The technique used must consider the patient’s ethnic group, culture, and race. “Therapists who understand and accept this theoretical position will have little difficulty modifying their technique in ways that take into account such determinants of behavior” (Lyles & Carter, 1982, p. 1123). Experience seems to indicate that African Americans clients have come from a different place and have many different ideas about counseling. The experience of slavery and subsequent treatment has impacted on the family in such a way as to influence the dynamics that go on within the family structure. This, in effect, causes the African American family to behave differently from other groups and to manifest its pathology in different ways. With respect to this differentiation, there is need to treat the African American family along slightly different lines than you would other groups. When a counselor engages a family, more than likely the counselor will be dealing with a family system that is different from the counselor’s own. The clinician has a value system, a cultural background, and a host of experiences, which will usually be different from the family being treated. It then becomes necessary for counselors to explore their own belief system, perceptions and prejudices. They also need to be aware of the cultural values of the families with whom they work (Boyd-Franklin, 1984). This is to imply that African American families are not homogeneous but are as heterogenous as the culture from which they live and must be treated as such. Inability to Afford Counseling and Motivation Many African Americans have not been able to afford counseling, and thus, have not grown accustomed to being able to utilize it. The individual has mostly considered counseling a luxury and has been concerned with more concrete issues (food, clothing, shelter). African Americans have always relied on a network of kinship, friendships, relatives, and neighbors for help, as well as counseling and guidance; with very little reliance upon community agencies (McAdoo 1977). The church and the extended family have always been important factors to consider when working with an African American family. This is seemingly true because of such factors as discrimination and racism, which cause them to tend to rely on a kin network rather than to trust outsiders. Counselors are usually considered outside this network and are therefore considered a threat to the confidential nature of their personal thoughts, feelings and troubles. The family may be unwilling to discuss personal issues until a relationship of trust has been developed (Boyd-Franklin, 1984). “While the white family may utilize a community institution, Blacks turn to their own family or extended family in times of crisis” (McAdoo, 1977, p. 77). In many cases, the family will find no resources to help with the family problems, and the resources that are available are not viewed as sympathetic to the minority experience. African Americans have a distrust for agencies. It is true that bureaucracies in the past have had a very racist way of prying into the affairs of families while providing services. So, the family has developed a distrust for agencies, feeling that the counselor is just another person prying into their “business.” Another issue is that African Americans are generally forced to come in for counseling by one institution or another—therefore they resist. A family that is more aware of the purpose of counseling and comes on their own will likely be more motivated to come for the treatment session. The counselor must be active and extend themselves to acquaint the family with the therapeutic process (Boyd-Franklin, 1984). Confidence and trust must be earned; it is not automatically given (Sager & Braboy, 1970). Resistance of African American Clients. “Community services are often not utilized until a conflict occurs with an institution within the wider community, such as the police or the schools” (McAdoo, 1977, p. 77). If these clients are to be engaged the counselor must clarify the role of the referring agency, and the role of the counselor. When referred to another agency, the family will usually resist because they are not actually volunteering to come because of a felt need but are being forced to come. This will cause the family to behave differently while engaged in counseling. Experience in counseling indicated that African Americans have difficulty with trying to physically come for counseling. Clients will say that they forgot about the session; had other urgent matters to address; say they didn’t have the bus fare; that they didn’t feel well; or make other excuses for missing the session. The main reason being poor motivation for coming and being able to place a high value on the counseling relationship. It has been noted in the work of several authors how reluctant and resistive to treatment the African American client seems to be (Foley, 1975; Sager & Braboy, 1970; McAdoo, 1977; Boyd, 1977). The African American family has the same kind of resistance that other families have, as well as the specific resistances peculiar to their own circumstances. It can be disastrous for the counselor to deny suspicion, resistance, and hostility, and not take these factors into account (Boyd-Franklin, 1984). In a recent survey of family therapists (Boyd, 1977), 43 percent saw Black families as more “resistive” to therapy than white families. Clinicians made such comments as: “Black families do not come in. It’s harder to keep Black families in therapy; or Black families perceive the therapist as threatening or prying. Other clinicians felt that therapy is a new, unfamiliar experience for Blacks. They are less willing to talk about their problems with an outsider” (p. 56).