African Americans and Therapy

Over 10 years ago, I decided to pursue a doctoral degree in psychology with an interest in developing expertise in providing therapy to underserved populations such as African Americans. This desire was sparked as an undergraduate psychology student when I noticed that often times African American are reluctant to seek treatment due to stigma and negative views towards psychological services. There is a plethora of literature on race/ethnicity and mental health services use. Overall, studies consistently report that African Americans have a higher unmet need than Whites with regards to seeking treatment for mental health issues (e.g., depression or life stress) for themselves or their children. As someone who grew up in the church and now works as a clinical psychologist, I see the value in both spirituality and psychotherapy.

African American families have a long standing history of preferring to use the bible and religion as a method of coping with life troubles and stress. Studies have found that African Americans report higher levels of religious and church involvement than the general population (Boyd-Franklin, 2003). As a result of this preference, many African Americans view seeking treatment for mental health problems as less desirable or less culturally acceptable. Some researchers have stated that African Americans may believe that if they see a therapist they may be seen as spiritually weak by people close to them (Mishra and colleagues, 2009).

It has been noted that in African American families prayer is often used to cope with physical health (e.g., pain or cancer) and mental distress (e.g., acting out behaviors, depression, or grief). Dr. Boyd-Franklin emphasizes in her book how many “African Americans have a strong core of spiritual beliefs that empower them and give them strength to cope with stress.” For example, when confronted with a stressful situation an African American may say “God will give me the strength to overcome all obstacles.” Given African American families often frame issues in religious terms, it is important for therapist to not dismiss these religious beliefs as it may result in treatment dropout or poor compliance with recommendations. Ethically, psychologist are bound to the Ethics Code(Principle E: Respect for People's Rights and Dignity) which notes that psychologistare aware of and respect (their clients) cultural and/or religious beliefs. Therefore, it is important that all professionals explore this issue with their clients.

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