For years I have heard substance use disorders professionals discuss culturally sensitive, culturally specific, afro-centric, African centered treatment for African Americans with substance use disorders. When I hear them describe their ‘Afro-Centric Program’ it is often, business as usual. In this post I will share my view of components of a program that is culturally responsive to the treatment needs of African Americans Seeking Treatment.
The Program Creates a Welcoming Environment. This can include warm and sincere greetings, pictures on the wall and magazines in the waiting room which reflect African American culture, a tour of the facility and positive service from the intake specialist. This says to African American clients, you are welcome here!
African American Staff. While I am not suggesting that all the staff need to be African American, research indicates that when African American clients work with African American counselors trust is developed quicker, the clients feel less of a need to code switch, that is, changing their dialect or style of speech to make the counselor comfortable. They also stay in treatment longer when working with Black counselors and they make more progress. The organization should strive for inclusion at all levels of the organization. When race determines who gets promoted, turnover among African American staff is the likely outcome. When that occurs, African American clients suffer.
Materials Which Reflect African American Culture. It is important that reading materials, audiovisual materials reflect the experiences of African Americans seeking recovery so that they can see themselves in the material.
Respect For the Diversity of African American Culture. In the book, Disintegration: The Splintering of Black America, Pulitzer Prize writer Eugene Robinson describes 5 sub-groups in the Black Community. The groups include: The Culturally Elite, which is the rich and influential such as Oprah Winfrey, Michelle and Barack Obama, Biillionaire Robert Johnson etc; The Bi-racial group, including individuals such as Halle Berry, Don Lemon, Tiger Woods, Naomi Osaka, Barack Obama; The Middle Class, which is the majority of African Americans; The Emergent, recent immigrants from Africa and the Caribbean Islands; The abandoned, 25% of African Americans who live in generational poverty. It is clear that there are cultural differences between each sub-group, therefore, a one size fits all treatment plan for African Americans would be ineffective.
Holiday Celebrations. Treatment centers often celebrate holidays. Consider adding Frederick Douglass Day to the list of celebrations. According to historian William White, MA, Frederick Douglass was the first prominent American Recovering Alcoholic. Another Holiday to consider is Malcolm X Day. In recovery, Malcolm was an advocate for millions. Another holiday to consider is the annual Afeni Shakur day. She was the mother of rap star Tupac Shakur. At the time of her death she was in long term recovery and founded the Tupac Shakur Center for Performing Arts. These holidays could be celebrated on the birthday of these 3 great recovery pioneers. These celebrations could send the message to African American clients that they are important and provide drug free celebrations for them post discharge from treatment.
Family Involvement. In African American culture the extended family is the primary unit. Efforts should go into assertive outreach by staff to involve the family in treatment.
Trauma Informed Care. Trauma is at the care for many clients with substance use disorders, including African American clients. For African American clients, this trauma often includes dehumanizing experiences such as: police stop and frisk, police brutality, police arrests, jail and prison, trauma, the trauma of shopping and eating in restaurants while Black. Trauma also includes community and family violence. Programs striving to be culturally responsive to the needs of African Americans seeking recovery should provide training on the organizational level on how to become a trauma informed system of care and provide training for front line staff on unique trauma experienced by African Americans and how to address that trauma and retraumatizing them while in treatment.
Continuous Care. We often use the term aftercare, but often aftercare is an afterthought. Continuous care often involves creating a plan to help support the recovery of African American clients post discharge from a current level of care. Continuous care planning can involve making referrals to mutual aid groups with reputations of being African American friendly and helpful. It is important to be aware of the community African American clients are returning to and discover in discussion with the client community factors which help support recovery and community factors which put the client at risk for relapse. Protective factors can include: a family that is supportive of recovery, jobs, prosocial recovery support groups, recovery coaches indigenous to the community. Risk factors include: easy access to drugs; the absence of drugs, a non-supportive family and the absence of mutual aid groups which support recovery
Continuous care planning can involve a plan to connect with the protective factors and avoid the risk factors. It is important to remember that African American clients have different stressors. Stress for those working in corporate America can include dealing with micro-aggressions, micro-insults and micro-invalidations. Those living in economically poor communities might have to deal with community violence which could trigger traumatic stress disorders. Others might be dealing with racial identity issues in recovery as First Lady Michelle Obama stated, My husband Barack Obama was too Black for some people and too white for others.
Conclusion. This writing was meant to be a start. Not a complete blueprint on how to provide culturally responsive services for African Americans seeking treatment and recovery. To learn more, click here http://www.museumofafricanamericanaddictionsrecovery.org/webain