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Topics: Black people, Family therapy, African American Pages: 34 (9556 words) Published: October 10, 2013
Journal of Marital and Family Therapy
doi: 10.1111/j.1752-0606.2009.00166.x
April 2011, Vol. 37, No. 2, 153–168

Christiana I. Awosan
Drexel University

Jonathan G. Sandberg
Brigham Young University

Cadmona A. Hall
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.

Researchers have indicated that Black clients underutilize therapeutic services and are inconsistent in their usage of the services once sought (Brown, 2003; Neighbors, 1988; Sussman, Robins, & Earls, 1987). Research on Black clients’ attitudes toward and experience with therapeutic services has highlighted several key issues: premature termination (Sue, Fujino, Hu, Takeuchi, & Zane, 1991; Terrell & Terrell, 1984; Tidwell, 2004), racial and ethnic match between client and therapist (Laszloffy & Hardy, 2000; Snowden, 1999), psychological misdiagnosis (Garretson, 1993), and cultural mistrust (Hardy & Laszloffy, 1995; Terrell & Terrell, 1984; Whaley, 2001). Although several studies (Nickerson, Helms, & Terrell, 1994; Terrell & Terrell, 1984; Thompson, Bazile, & Akbar, 2004; Watkins & Terrell, 1988) have examined the obstacles that Black clients face in their attempts to utilize therapy, few studies examine how Black clients make meaning of their experience in therapy (Brown, 2003; Ward, 2005). No studies can be found that explore how Black clients attending therapy sought to overcome these obstacles. The purpose of this study is to better understand the obstacles that Black clients face in their effort to utilize family therapy, their attempts to overcome these obstacles, and how therapy can be beneficial to them.

Given the diversity in demographic factors among individuals of African descent (Hardy, 1989), it is important to recognize the variations among Blacks as these differences relate to the underutilization of therapy. People of African descent are not all the same (Hardy, 1989); the rich differences among Black families relate to many factors, such as unique cultural orientations, varying circumstances related to geographic location, and distinct differences in cultural values and beliefs. Although it is problematic to make a generalization of sameness for Blacks across the world, Ahia (2006) did note some similarities: ‘‘Afrocentric scholars are in general

Christiana I. Awosan, MA, Drexel University; Jonathan G. Sandberg, PhD, Brigham Young University; Cadmona A. Hall, PhD.
Address correspondence to Christiana I. Awosan, Drexel University, Couple and Family Therapy, 1505 Race Street, Philadelphia, Pennsylvania 19102; E-mail:

April 2011



agreement that there exists a composite of African-oriented existential tendencies, philosophies, behaviors, ideas, and artifacts among people worldwide who trace their roots to Black Africa’’ (p. 57). According to Boyd-Franklin (1987) and Wilson and Stith (1991), Blacks are fairly united in their negative perceptions of therapy. Their ‘‘negative’’ attitudes toward therapy can be linked to shared experiences of racism and oppression in a White society (Hardy & Laszloffy, 1995). However, based on education...

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