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Cultural Awareness and Competence 1 Cultural Awareness and Competence with African-American Clients Leah Packard LSW/CDCA Capella University SWK5012(3): Cultural Competence and Social Work Practice with Diverse Populations Dr. Renanda Dear December 15, 2023

Cultural Awareness and Competence 2 Population Selection and Justification According to Appleby, et al. (2010) “The experience of African Americans in the United States is unique … No other groups entered the society as involuntary immigrants, and no other group was subsequently victimized by two centuries of slavery .... ” Unfortunately, the subjugation of African Americans continues to persist in modern American Culture. The beauty of the culture such as customs, dress, and even hair continue to be portrayed as unacceptable and are discriminated against in various settings (Martin, A., 2017). White people of all ages, socio- economic statuses, and religions have claimed in one sentence to not be prejudiced against African Americans yet, in the next sentence justify the police killing of an unarmed African American man (on multiple occasions) (Deversi, M., 2016). Discrimination continues to be a major problem bread into our culture since its inception and is often based on ethnicity or color (Appleby, et al. 2010). Workers need to have a deep knowledge understanding of how the legacy of slavery, racism, discrimination, and internalized oppression affect the social functioning and psychological well-being of African-American Clients (Appleby, et al., 2010). In Ohio, Black Ohioans make up 45% of the state prison population, but only 17% of treatment court participants are Black (Health Policy Institute 2021). I work with clients navigating the criminal justice system (facing charges, returning home from prison, or entering treatment instead of conviction) at The Oriana House Inc., in the Treatment Department. Many of my clients are African-American males. I have noticed an uptick in the number of African- American males entering treatment for substance use disorders (SUD) and mental health concerns. I have also noticed an undeniable disparity between the sentences of my white male clients when compared to my Black male clients. I want a better understanding of how to advocate for fair sentencing practices, equity, and other important issues for my African- American Clientele.

Cultural Awareness and Competence 3 While I have some knowledge of African-American culture and the history of racism, prejudice, discrimination, and oppression. I do not feel proficient enough to understand the unique challenges they face accessing services and would like to better understand and grow in my ability to provide culturally competent services to them. Our core values implore us to fight for social justice, enhance the dignity and worth of our clients, and enhance cultural competence (NASW, 2021). Given my clientele, it is my ethical responsibility as I see it to enhance my cultural sensitivity and cultural awareness of the African-American population I currently serve, to understand, provide competent services, and advocate for equality, equity, and develop treatment interventions that are inclusive of their unique cultural considerations. Culturally Relevant Research Conducted in the African-American Community The first study analyzed looked at suicide and protective factors among African Americans. This study, being culturally informed, focuses on the protective factors African Americans have against suicide, while also highlighting the lack of appropriate research and interventions for African Americans. This study also pointed out that suicide among African Americans has been a neglected topic while suicide rates are steadily increasing every year (Reed et al., 2021). They found that since 1998 suicide rates have increased by 24% for the public but rates have increased by 30% among African Americans; and raw numbers for suicide show a 57% increase in suicide for African Americans since 2013 (Reed et al., 2021). The authors used critical race theory to examine protective factors specific to African Americans that may mitigate suicide risk. They performed a literature review of social work research from 1980 to 2018 (which revealed the lack of contribution by the social work discipline as there were only 20 suicide-related studies) to examine social work’s contribution to research on suicide-specific studies and examine protective factors for African Americans (Reed et al., 2021).

Cultural Awareness and Competence 4 Results showed that on a micro-level, private regard and strong African American identity were protective factors as well as aggression and impulsivity in response to discrimination causing outward violence which protects against suicide but could lead to criminality (Reed et al., 2021). At a Mezzo-level family support and the role of women are protective factors (Reed et al., 2021). Macro-level factors included social/peer support, poverty, and education/awareness in that poverty decreases suicidal ideation while education increases risk due to attainment not paying off, it also found that religion, access to care, and internal response to community violence are protective factors (Reed et al., 2021). They proposed that the use of Critical Race Theory, increasing minority-inclusive research, interventions, models, and theoretical approaches to suicide research are essential because generalizing all populations in suicide research ensures that “the needs and empowerment of suicidal African Americans will continue to be misunderstood, over-looked or ignored.” (Reed et al., 2021). The second study examined the relationship between Race-based traumatic stress symptoms (RBTS) and traditional trauma symptoms in Black Americans (Roberson & Carter, 2022). The study recruited 230 African American participants over half male. Findings promote a need for practitioners to understand that trauma symptoms may differ regarding racial discrimination experiences among African Americans (Roberson & Carter, 2022). They urge clinicians working with Black clients to look beyond instruments and interact with them to discern if they are exhibiting symptoms of trauma despite low hypervigilance scores and to focus more on self-esteem and anger symptoms (Roberson & Carter, 2022). I found this study highlights the need for developing culturally sensitive measurement tools to address symptom presentation which might vary between different cultures to assist in diagnoses. It also reinforces

Cultural Awareness and Competence 5 that clinicians must remain ever cognizant of how symptom presentation can differ based on one’s experiences and culture. The third study investigated the degree to which experiences of racial discrimination in African Americans are related to negative mental health outcomes (post-traumatic stress disorder (PTSD), depression, and anxiety) while controlling for the influence of negative affectivity (Mekawi et al., 2021). The study sampled 419 African American adults (56.1% women) from 18 to 78 years old, 22.2% had less than a high school education, 43.2% completed or earned a GED, and 33.9% completed additional education (Mekawi et al., 2021). Monthly income was as follows, 41.1% reported earning less than $500 per month, 25.3% less than $999, and 30.5% reported an income of $1,000 or more per month (Mekawi et al., 2021). They used various inventories to measure experiences of discrimination, to measure PTSD, depression, anxiety, and personality symptoms (Mekawi et al., 2021). They found that experiences of discrimination were associated with adverse mental health outcomes even when controlling for negative affectivity (Mekawi et al., 2021). They report that some researchers have attempted to criticize the notion that experiences of racism correlate to negative mental health outcomes and that rather negative affectivity or personality traits were more the blame (Mekawi et al., 2021). The study has relevant clinical implications in that clinicians need to be diligent in addressing how their racial ideologies interfere with their ability to provide culturally competent services (Mekawi et al., 2021). It was alarming that professionals in the field would to this day attempt to minimize the impact of racism, discrimination, and oppression and essentially attempt to shift blame to the victim. They call for clinicians to reconceptualize their client's race-related

Cultural Awareness and Competence 6 distress by recognizing all the interpersonal and structural factors that affect the client’s functioning instead of pathologizing the client’s lived experience (Mekawi et al., 2021). Theories and Methods When working with African American Clients I feel that using the empowerment theory and methods is a way to address not only the client but the larger environment and systems the client operates in. Empowerment theory in short links individual strengths/resilience, natural helping systems, and proactive behaviors to social policy and social change (Perkins & Zimmerman, 1995). Empowerment theory posits that we think in terms of wellness, competence, and strengths when it comes to clients and communities (Perkins & Zimmerman, 1995). African philosophy summarizes that no one can be self-sufficient and that interdependence is a reality for all people (Skene, K., 2022). The resilience of the individual is a combination of personal and environmental factors (Skene, K., 2022). Empowerment theory seeks to increase personal, interpersonal, and political power so that individuals and communities take the steps necessary to improve their lives and functioning (Perkins & Zimmerman, 1995). Appleby et al., (2010) suggest as well that social workers must practice from a theory that people of color are vulnerable to racism and victimization. It is also suggested to keep in the forefront power-conflict theory as this theory helps to establish a frame of reference putting the spotlight on the psychological and sociological effects of power and oppression (Appleby et al., 2010). Power-conflict theory enables social workers to understand certain behaviors and explains our clients who are discouraged or estranged (Appleby et al., 2010). Historical and Contemporary Antecedents of Discrimination

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