Understanding the Experience of Black Clients in Marriage and Family Therapy

Abstract

Past research on Black clients' utilization of therapy focused on the barriers that prevent Black clients from attending therapy and the reasons for these barriers. However, few studies have been conducted that focus on how Black clients attending therapy actually experience these barriers. This study utilized both Likert and open-ended questions to examine the obstacles 16 Black clients face in their attempts to attend family therapy. The most frequently identified obstacles were related to concerns over family member response and cultural barriers to therapy. Participants also reported concerns about racial and/or cultural differences and a lack of understanding by non-Black therapists. The implications of this study addressed how to effectively meet the therapeutic needs of Black clients.

“We Shall Overcome”: A Qualitative Exploratory Study of the Experiences of African Americans Who Overcame Barriers to Engage in Family Therapy

“…Clinicians should not assume that African Americans are going to teach them about their culture (Awosan et al, 2011). This assumption is faulty in that it fails to take into account power and hierarchy within the therapeutic relationship (Hardy & Laszloffy, 2002).…”

“…Secondly, clinicians should overtly inquire about access barriers participants may be attempting to overcome (Awosan et al, 2011). With this information, family therapists can begin to intervene and address barriers that will undermine successful therapy immediately and impact engagement (Wang et al, 2006).…”

“…For many African American families, talking about their private business with folks outside of the family is taboo (Awosan et al, 2011). Prior to experiencing therapy, many people do not understand the rules of confidentiality and may be fearful of its violation.…”

“…A. Hall and J. G. Sandberg Hall, 2011). African Americans are also more likely to receive a misdiagnosis or a severe diagnosis, such as schizophrenia, than White clients who present with similar symptoms (Baker, 2001).…”

African American Pastors on Mental Health, Coping, and Help Seeking

“…Some of the barriers to African Americans’ mental health help‐seeking behaviors include stigma (Awosan, Sandberg, & Hall, ), denial of symptomatology, an external locus of control regarding their health (Andrews, Stefurak, & Mehta, ; Ayalon & Young, ), preference for an African American counselor (Awosan et al, ; Townes, Chavez‐Korrell, & Cunningham, ), alternative beliefs about the etiology of mental health issues (Farris, ), cultural norms in African American communities (Awosan et al, ), and cultural mistrust (Townes et al, ). These barriers may be more prevalent for African Americans living in rural areas (Murry, Heflinger, Suiter, & Brody, ), which is troubling, because most African Americans reside in rural areas of the southern United States (U.S. Department of Health and Human Services, ).…”