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Antwone Fisher-Cross Cultural Psych

Spring 2013 Final Assignment
by

Sara Alexander

on 8 April 2013

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Transcript of Antwone Fisher-Cross Cultural Psych

Foundation Antwone's Underlying Issues Culturally Competent Treatment for Antwone Antwone's Strenghts Underlying Aggression Issues in Therapy: African American Males
Antwone was born in prison to a drug addict mother
Father murdered before he was born
Grew up in foster care where he was physically, mentally, and sexually abused
Great deal of internalized racism
After watching best friend get shot, joined the Navy

Antwone Fisher At the beginning of the film he has few resources
By the end he has a large family support system, a loving girlfriend, and Dr. Davenport
Prevailed despite his abusers
Determined, intelligent, and strong- he has the will to succeed and overcome
He has the abiltiy to accept change and be flexible
Aggression as a means to take control in response to his lack of control in childhood
Avoids intimacy due to inabiltiy to trust and fear related to physical connection
Physical violence easily accessible due to childhood abuse
Has internalized negative stereotypes about blacks but also does not trust whites
Insecure in his role as a black man
Identity confusion
High environmental demand without resources to cope (Ramseur, 1991)
Sara Alexander
Cross Cultural Psych
Spring 2013 Presenting Problem: Extreme anger issues
Underlying Problems:
Skeptical of therapeutic benefits
Fear of intimacy
Inabiltiy to trust or let his guard down
Lack of confidence
Self-hatred
No social support National Survey Results Difficult for black males to develop sense of self while competing with stereotypes
Blocked from economic and educational oppotunities that provide a positive self-image
Inabiltiy to provide for their family may be damaging to self-esteem
Suicide is the third leading cause of death (Thorn & Sarata, 1998)
Intra-psychic conflict leads to anxiety, depression, rage, and anger
Frustration may cause them to lash out and respond with anger
Stigma related to help and therapy-seeking
Antwone's Background Presenting Problem Assistance in accepting his African American cultural identity
Help establish a support system
Understand his problems within a societal and environmental context
Consider his mental health in individual terms along with his connection to society and peers
Help him increase pride of being part of a group that overcame immense obstacles
Cope with and express emotions with problem-focused and emotion-focused strategies and increase his cognitive flexibility Weak racial and cultural identity
Mistrust of whites
Poor self-concept
Anger about molestation and fear of intimacy Therapeutic Issues with African Americans Each individual experiences racism differently
May feel devalued, dehumanized, and frustrated
Social conflict between being "ghetto" or too white (Johnson, 2006)
Cannot assume all blacks have similar cultural backgrounds
Discrimination linked to anxiety and depression, with men reporting higher degrees of percieved discrimination (Banks, Kohn-Wood, & Spencer, 2006)
Protective Cultrual Elements Social networks and support systems: barber shop, social clubs, local gathering spots
Black men, more than most races, utilize friends to dicuss relationship, social, and sexual problems
Church community and religion Why Don't African Americans Seek Treatment? Stigma related to seeking psychological treatment or therapy
Only 48% of African Americans with depression and 32% with a mental disorder seek treatment
Lack of priority due to confluence of other problems
Financial obstacles
Percieved discrimination in treatment
Difficulty attaining an African American therapist
Social pressure to be be strong

References Banks, K.H., Kohn-Wood, L.P., & Spencer, M. (2006). An examination of the African
American experience of everyday discrimination and symptoms of psychological distress. Community Mental Health Journal, 42 (6), 555-570.

Bridges, E. (2010). Racial identity development and psychological coping strategies of
African contextualized humanistic perspective. Counseling and Values, 50, 187-196.

Forret, J. (2008). Conflict and the “slave community”: Violence among slaves in uncountry
South Carolina. The Journal of Southern History, 74 (3), 551-588.

Johnson, P.D. (2006). Counseling African American men: A contextualized humanistic
perspective. Counseling and Values, 50, 187-196.

Jones, B.E. & Gray, B.A. (1983). Black males and psychotherapy:
Theoretical issues. American Journal of Psychotherapy, 37 (1), 77-85.

Ramseur, H. (1991). Psychological healthy black adults. In R.L. Jones (Ed.), Black
Psychology (p. 353-378). Berkley, CA: Cobb & Henry.

Thorn, G.R. & Sarata, B.P. (1998). Psychotherapy with African American men: What we
know and what we need to know. Journal of Multicultural Counseling & Development, 26 (4), 240-254.
Utsey, S. & Payne, Y. (2000). Race-related stress, quality of life indicators, and life
satisfaction among elderly African Americans. Cultural Diversity & Ethnic Minority Psychology, 8 (3), 224-233.

Wester, S.R., Vogel, D.L., Wei, M., & McLain, R. (2006). African American men, gender
role conflict, and psychological distress: The role of racial identity. Journal of Counseling and Development, 84 (4), 419-429.

Woodward, A.T. (2011). Discrimination and help-seeking: Use of professional services and
informal support among African-Americans, black Caribbeans, and non-Hispanic whites with a mental disorder. Race and Social Problems, 3 (3), 146-159.

Survey of African Americans, black Caribbeans, and non-Hispanic whites
24.2% African Americans used informal support alone; 56% of whites recieved both professional and informal help; 26% of black Caribbeans got did not recieve any help at all
Those with lower incomes and less education tended to rely more heavily on informal support (Woodward, 2011) The Slave Community While religion and closeness of family unit were protective, slaves could not escape the psychological damage of violence and racism
Violence often bred violence within the slave community
A great deal of fighting among slaves
Problems with domestic violence and abuse passed on from generation to generation Focus of Therapy for Antwone Reconcile societal prejudice and develop an ethnic identity
Needs to redefine himself and reject stereotypes
Must reconcile both his American and African idententies and values
Goal: integration phase of ethnic identity
Teach him positive, problem-focused strategies that include social support (Bridges, 2010)
Elucidate issues of internalized racism Racial Identity Development Often difficult for African American males to find balance in their ethnic identity: African American and Eurocentric society
Poor ethnic identity often results in feelings of anger and confusion
Delicate balance to be accepted by both native culture and majority culture
Possible outcomes: alienation, assimilation, withdrawal, or integration
Achieving integration allows for a more positive and secure sense of self (Bridges, 2010) (Bridges, 2010) Conceptualizing Mental Health for African Americans "Mental health" may need to be defined differently
Need to adapt to a unique social and cultural environment
Important issues: racism, adapting to white institutions, maintaining a role within African American community, coping with limited power due to discrimination
Explore the interaction among racial identity, gender role, and internalized racism (Wester, et al., 2006) Impact of Racism Many documented psychological and physical impacts of chronic racism
Creates a chronic stressor with long-term, negative effects
Associated with poor psychological and somatic health in African American men
Physiological effects: cancer, heart disease, hypertension, and cirrhosis of the liver
Psychological effects: low self-esteem, depression, feelings of helplessness, lower life satisfaction, trauma, and loss
How is Racism Expereinced? Personal Racism: expereince of racism aimed at the individual
Institutional Racism: results from policies and laws that exclude African Americans
Cultural Racism: exclusion of contributions of African Americans in American history
(Jones, 1997) (Utsey & Payne, 2000) (Forret, 2008) Conclusion Culturally competent treatment with African Americans needs to aim for the following:
Help reach the integration phase of racial identity development
Be sensitive to the specific culture, traditions, and history of the individual
Elucidate the historical strengths and achievements of African Americans
Help clients develop a strong sense of self within their cultural and social context
Be encouraging, non-judgmental, and empathetic
(Jones & Gray, 1983) (Bridges, 2010) (Ramseur, 2011) (Johnson, 2006) Culturally Competent Treatment for Black Men Build rapport and trust as soon as possible
Therapist needs to be knowledgable about African American history, tradition, and society
Be aware of personal stereotypes to avoid countertransference and discrimination
Allow them to maintain a level of personal control- cannot be too directive
Understand relationship with family and community
Connect with African American community through churches and community centers
Be flexible in techniques and approach to accomodate unique needs of client
Group therapy may be particularly effective
(Thorn & Sarata, 1998) Potential Conflicts Would likely be best for Antwone to have a Black therapist
Deep-seated internalized racism
Low frustration tolerance
Therapist would need to be patient, empathetic, and caring
Would take time
Potential to get overly dependent on and attached to therapist
Group therapy may be helpful to help avoid potential abandonment issues and build social support system
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