Culturally Alert Counseling: African Americans
Each ethnicity has its’ own unique personality and inclination (or not) towards the therapeutic process. The African-American community has a set of expectations and hesitations that will enhance the healing process or bring it to a premature termination. As counselors, it is our job to recognize these sensitivities as well as any barriers we contribute that might hinder a successful outcome. This document will briefly explore the unique characteristics of counseling within the African-American community and how we can take steps to ease the therapeutic process. The comments below represent common indications within the African-American population, but do not attempt to speak for everyone, realizing that there are those that would take exception to these views.
Characteristics
Past and Present Realities- The African-American culture is one that is shaped by history and influenced by current situations. Historical events such as slavery and civil rights still impact this culture. Attitudes of oppression and feelings of injustice have permeated this population for generations. To ignore this aspect within a client is similar to denying a foundational characteristic of their identity. African-American history may never actually be discussed within the therapeutic process, but a therapist needs to be aware that the effects still linger and to deny it or discount it could jeopardize the relationship. The same is true for current racial attitudes. Racism still exists in today’s society whether the therapist is aware of it or not.
Trust- This could be the most important aspect of any therapeutic alliance. Within the African-American community, trust is paramount. Past betrayals make trust an important issue. “Can I trust that the counselor understands my issues?”, “Will any of my comments be reported to other agencies?”. The perception is that the counseling profession is dominated by other white males that have very little understanding of the African-American community. They have often times experienced older white males in a negative context within government agencies or within the penal system. Individuals need to know the counselor understands their issues, will be strictly confidential, provides a safe environment, and is competent in what they do.
Community- Therapy is generally considered as a last resort for mental difficulties. Individuals will normally seek relief through churches and pastors, doctors, family, and emergency rooms at local hospitals before directly contacting a therapist. Often times, a counseling relationship will develop out of a referral from a secondary source. Because community and family are so important, an individual is not inclined to seek “outside” support. If the problem seems too difficult for the immediate community, they will often be referred to a professional or seek additional help on their own. There is a greater stigma within the African-American community towards therapy which adds to the reluctance to seek treatment. Certain illnesses such as schizophrenia, depression, or suicidal thoughts are deemed appropriate for therapy.
Reasons for not seeking therapy- As stated above, major reasons African-Americans do not readily seek mental health therapy are feelings of disconnect with the counselor/counseling process, trust/understanding issues, social stigma, and the desire to keep the issues within family or community. Other considerations include; general economics and gender roles such as the African-American woman being the nurturing source and the African-American male as strong and proud.
Recommended counseling considerations from African-American clients
1. Building trust and relationship should the first priority. The idea isn’t that you know or understand what the client is experiencing or has experienced, but that you are willing to listen, learn, and help them solve their problems.
2. In the initial sessions, explain and demonstrate confidentiality. Go over the ACA ethics guidelines and continue to reinforce as the client reveals more intimate details.
3. Have a client friendly office. Maintain appropriate magazines, artwork, books, etc… Hire a diverse staff.
4. Don’t try to pretend or assume that you understand more than you actually do. We all give off subconscious cues and indications through the things that we say and references that we make. These are picked up on very quickly and can impact the therapeutic relationship. Honesty is the best policy.
5. Discussing ethnicity in counseling sessions is not a bad idea, although it is usually best to wait until the client brings it up or until there has been a reasonable trust established. Otherwise, it will be often times be perceived as the counselor having a discomfort with the subject or just awkward.
6. Use more cooperative language. The term “counselor” is seen more as a helper instead of someone that tells you what to do. Psychotherapist has a more intimidating sound to it. Focus on comfortable language.
7. Clients will disclose in a layered response. All of the facts will not be disclosed right away, but in subsequent layers as they feel more comfortable and trusting. Important details will be left out of stories and responses until later sessions. Clients that are “court involved” will be even slower to disclose all of the facts.
8. African-American clients are more hesitant to seek treatment and may need to be sought out. A counselor may need to be visible in the community and perceived as “safe” and with a reasonable compassion. Your office may need to be flexible and allow for a certain amount of walk-ins.
9. Be willing to allow for a level of self-disclosure so the client will feel more comfortable.
10. As able, assist the client in exploring their ethnicity and sense of pride in their culture.
11. Assist the client in understanding the counseling process and the various types of disorders and symptoms. Help them to be more educated about their own symptoms and feelings. Make them a part of the treatment process.
Characteristics
Past and Present Realities- The African-American culture is one that is shaped by history and influenced by current situations. Historical events such as slavery and civil rights still impact this culture. Attitudes of oppression and feelings of injustice have permeated this population for generations. To ignore this aspect within a client is similar to denying a foundational characteristic of their identity. African-American history may never actually be discussed within the therapeutic process, but a therapist needs to be aware that the effects still linger and to deny it or discount it could jeopardize the relationship. The same is true for current racial attitudes. Racism still exists in today’s society whether the therapist is aware of it or not.
Trust- This could be the most important aspect of any therapeutic alliance. Within the African-American community, trust is paramount. Past betrayals make trust an important issue. “Can I trust that the counselor understands my issues?”, “Will any of my comments be reported to other agencies?”. The perception is that the counseling profession is dominated by other white males that have very little understanding of the African-American community. They have often times experienced older white males in a negative context within government agencies or within the penal system. Individuals need to know the counselor understands their issues, will be strictly confidential, provides a safe environment, and is competent in what they do.
Community- Therapy is generally considered as a last resort for mental difficulties. Individuals will normally seek relief through churches and pastors, doctors, family, and emergency rooms at local hospitals before directly contacting a therapist. Often times, a counseling relationship will develop out of a referral from a secondary source. Because community and family are so important, an individual is not inclined to seek “outside” support. If the problem seems too difficult for the immediate community, they will often be referred to a professional or seek additional help on their own. There is a greater stigma within the African-American community towards therapy which adds to the reluctance to seek treatment. Certain illnesses such as schizophrenia, depression, or suicidal thoughts are deemed appropriate for therapy.
Reasons for not seeking therapy- As stated above, major reasons African-Americans do not readily seek mental health therapy are feelings of disconnect with the counselor/counseling process, trust/understanding issues, social stigma, and the desire to keep the issues within family or community. Other considerations include; general economics and gender roles such as the African-American woman being the nurturing source and the African-American male as strong and proud.
Recommended counseling considerations from African-American clients
1. Building trust and relationship should the first priority. The idea isn’t that you know or understand what the client is experiencing or has experienced, but that you are willing to listen, learn, and help them solve their problems.
2. In the initial sessions, explain and demonstrate confidentiality. Go over the ACA ethics guidelines and continue to reinforce as the client reveals more intimate details.
3. Have a client friendly office. Maintain appropriate magazines, artwork, books, etc… Hire a diverse staff.
4. Don’t try to pretend or assume that you understand more than you actually do. We all give off subconscious cues and indications through the things that we say and references that we make. These are picked up on very quickly and can impact the therapeutic relationship. Honesty is the best policy.
5. Discussing ethnicity in counseling sessions is not a bad idea, although it is usually best to wait until the client brings it up or until there has been a reasonable trust established. Otherwise, it will be often times be perceived as the counselor having a discomfort with the subject or just awkward.
6. Use more cooperative language. The term “counselor” is seen more as a helper instead of someone that tells you what to do. Psychotherapist has a more intimidating sound to it. Focus on comfortable language.
7. Clients will disclose in a layered response. All of the facts will not be disclosed right away, but in subsequent layers as they feel more comfortable and trusting. Important details will be left out of stories and responses until later sessions. Clients that are “court involved” will be even slower to disclose all of the facts.
8. African-American clients are more hesitant to seek treatment and may need to be sought out. A counselor may need to be visible in the community and perceived as “safe” and with a reasonable compassion. Your office may need to be flexible and allow for a certain amount of walk-ins.
9. Be willing to allow for a level of self-disclosure so the client will feel more comfortable.
10. As able, assist the client in exploring their ethnicity and sense of pride in their culture.
11. Assist the client in understanding the counseling process and the various types of disorders and symptoms. Help them to be more educated about their own symptoms and feelings. Make them a part of the treatment process.
