Drug abuse and substance addiction is a problem that affects families across the globe. This problem does not discriminate. It affects individuals from all walks of life, regardless of class, age, and cultural background. As a result, it is a problem that affects everyone. To better understand and treat addiction it is important to include family into the therapeutic framework. This is because family relates to “the set of beliefs and values known as ideology and culture”, (McCollum & Trepper, 2001, p. 16). Culture directly influences the individual and their family such as styles of communication, roles, and expectations. Culture is important to counseling. It can predict and determine environmental stressors or even treatment outcomes. To provide effective therapeutic services for families facing addiction, counselors must adapt family-centered therapy strategies to meet the needs of cultural groups. This can be observed in the African American client.
There are factors which can contribute to the onset of substance abuse. These are observed within the family environment. It can be seen in different families from various religions, backgrounds, and socio-economic class. Research conducted by K.L Kumpfer found predictors for substance abuse within the family environment includes:
- Limited family bonding
- Chaotic home environment
- Poor parenting
- History of substance abuse
- Social isolation
- Poor communication of values
- Lack of discipline
Through the use of family-centered therapy, families facing addiction are able to learn interrelation skills, understanding, improved communication, improvements in parenting, and more. All of these qualities allow individuals and their families to overcome addiction and mend relationships. “Implemented to improve specific problem behavior such as substance abuse… family centered therapy can impact a broad range of other adolescent and adult outcomes such as improved school and job performance, mental health, delinquency, health, and goal attainment”, (Kumpfer, 2014). This is done by engaging family support through understanding and setting goals. However, to address the needs of the individual and their family, counselors must be aware of, acknowledge, and adapt to family culture and cultural differences. This is important to providing effective treatment and positive outcomes.
African Americans represent a unique culture within American society. They are impacted by a history of American slavery, racial discrimination, and social disparities in incarceration, class, and educational outcomes. In addition, African American families are more likely to drop out of therapy and less likely to seek out counseling. (Kelly, 2006). For this reason, therapist must practice cultural sensitivity to encourage participation and growth. When working with all clients whether they are culturally different are similar, counselors must be (1) aware of the significance of culture (2) use cultural differences as an expansion of self and (3) develop uniqueness and understanding of cultural differences, (Kelly, 2006). The best way to do this is to talk about culture. Openly discussing cultural traditions and values that set African Americans apart, counselors can gain an understanding of the African American family.
The aim of family-centered therapy is to treat the family and not the individual. In this way the family is observed as a functioning unit. Culture affects individuals and the whole family. When counseling a family that is culturally different, counselors must modify treatment according to cultural needs and dynamics. Research found that “adapting the program to target the needs and cultural sensitivities of the families… increased program success”, (Kumpfer, 2014). It is important for therapist to address the culture and cultural differences observed in families. This includes validating, supporting, and acknowledging cultural similarities and differences. Gaining understanding of how culture shapes the family structure, counselors can apply appropriate strategies for treatment and improved treatment outcomes. It can be done by taking simple measures. “Therapists may respectfully ask African Americans to share aspects of their heritage and background of which they are proud, and then acknowledge and validate those strengths”, (Kelly, 2006, p. 109). This can help clients and counselors to develop a rapport with one another and establish comfort as well as address cultural assumptions. In addition, counselors can also use this as an assessment tool and strategy for treatment. For instance, when these cultural strengths are lacking within the family it can be used as a goal to rebuild and reinstate cultural values.
Racism, discrimination, and cultural stereotypes are a problem facing African American families. It also negatively affects individuals within the family as members can internalize these assumptions. When this happens it can encourage poor mental health for the client and his or her relationships with others. “Negative racial identity is strongly associated with greater personal distress… therapist need to assess the degree to which their African American clients internalize racist and self-blaming societal messages”, (Kelly, 2006). This is important because it can affect family structures, roles, and rules. African American men, especially feel the pressures of society including racial bias and cultural stigma. They may feel worthless, less likely to succeed, or encouraged to meet the demands of racial stereotypes. When this occurs it affects the roles and rules for African American women and their relationship with their loved one. In this case women may feel the need to verbally castrate male family members or test their boundaries or male identity. According to Kelly this is also a common theme found in African American families because it comes from social stereotypes. As a result, negative themes related to the African American identity are most often found in those suffering from substance abuse, (Kelly, 2006).
“Family systems theory recognizes and respects the importance of each system in the ecology of the individual, from his or her own internal processes to the social and cultural forces”, (McCollum & Trepper, 2001, p. 16). Family systems theory recognizes the importance of culture and how this shapes the individual and the family unit. This includes the African American culture and family dynamics. Black families are heavily affected by incarceration, single-parent households, and single-mothers. It is a common assumption that African American households are fatherless homes, some children do not know or have a relationship with their father. Regardless of these myths, African Americans are heavily impacted by racial stereotypes and cultural disparities. Family centered therapy recognizes the importance and influence of family as well as how individuals are affected by the family structure. For this reason, family systems theory is a therapeutic approach that is popular to treat individuals suffering from substance abuse. This is because family systems theory recognizes the risks and stressors which stimulate and contribute to addiction. By attacking the problem within his or her family environment, members can develop strategies to improve on themselves as well as their relationships with others. As a result, research has found that, “family based interventions are the most effective way of preventing or treating substance abuse”, (Kumpfer, 2014).
Kelly, S. (2006). Cognitive-behavioral therapy with African americans. In P.A Hays & G.Y Iwamasa (Eds.) Culturally responsive cognitive behavioral therapy: Assessment, practice, and supervision (pp. 97-116). Washington, DC: American Psychological Association. Retrieved from: http://gsappweb.rutgers.edu/cstudents/readings/Summer/Kelly_Diversity/Kelly%202006%20CBT%20with%20African%20Americans.pdf
Kumpfer, K. (2014). Family-based interventions for prevention of substance abuse and other impulse control disorders in girls. International Scholarly Research Notices Addiction. 2014(2). 1-23. Retrieved from: http://www.hindawi.com/journals/isrn/2014/308789/
Snyder, W. (2013). Understanding the family in context: Family systems theory and practice. In E.E McCollum & T.S Trepper (Eds.) Family solutions for substance abuse: Clinical and counseling approaches (pp. 11-33). New York, NY. Routledge Press.