This document discusses counseling considerations for older African Americans. It notes that historical experiences like the Tuskegee Syphilis Study have led to distrust of the healthcare system. There are also interpersonal and societal forms of distrust. While the population of older African Americans is growing, they remain underrepresented in nursing homes compared to whites. They also have higher rates of health issues but are more likely to be hospitalized than receive outpatient care. Treatment for older African Americans must acknowledge racism, focus on strengths, and avoid biases. Barriers to seeking treatment include social stigma, lack of access and resources, and "healthy cultural paranoia." Communication styles may also differ.

1. Counseling Older African
Americans
Jasmine Spearman
Mary Scouten
Kymani Hayden

2. ● African-Americans have had historical
experiences that have shaped the
following generations’ perceptions of the
helping professions
● The Legacy of Tuskegee
● The Legacy of Distrust
● Science vs. Human Rights
History of African Americans in US

3. ● Interpersonal Distrust : “...Based on
personal experiences and interactions of
individuals with health care or clinical
research settings”.
● Societal Distrust: “... Characterized by a
global negative outlook on clinical
research based on perceptions of
collective research entities or life
experiences in society at large”.
Types of Distrust

4. Demographics:
● 2 million African Americans ages 65> represents 8% of
the Af Am population.
● Rate of growth of older Af Am exceeds the rate of
growth of general population.
● The % of Af Am elders is lower than White Americans.

5. African Americans Health Perception/
Prevalence:
● 17% of African Americans rate their health as poor
● 3% live in nursing homes
● 12% of African Americans are institutionalized compared to 23% of whites
are institutionalized.
● 28.1% have alcoholism, drug abuse, and mental health care problems
● More likely to be hospitalized rather than placed in outpatient care settings
(possibly because of access to health care/insurance)

6. Cultural Practices:
African American values vary:
● Some come from cultural practices from Africa
● Some come from adaptations of American cultural norms
● Some come from personal experiences with mainstream culture
● African Americans emphasize spirituality and sharing→ many go to clergy for help rather
counseling

7. Differences within group:
● African Americans at poverty level or lower income views differ from
middle and upper class
● Lower income focus on present day concerns
● Community intolerance to those with mental illnesses
● Most African Americans in urban areas follow popular health care beliefs.
● Immigrants from Africa or the Caribbean who live in urban areas, however,
may also assume traditional folk traditions.

8. Therapists/Treatment of African
American:
● Must be aware of desire to focus on day-to-day issues when treating African Americans
● Need to understand impact of racism today as well as the legacy of slavery experience
● Therapeutic bias is based on unfounded assumptions
● Need to be aware of “invisible syndrome” and address racial identity issues in counseling
● Treatment needs to be directed towards enhancing existing strengths within individual, family,
and community
● Attention must be paid to the potential for counselor bias as African American clients are more
likely to be rated as impaired, less verbal, and in families with poor relations

9. Why They Don’t Seek Treatment:
● Social stigma against counseling
● Lack of accessible resources (like health care) and opportunities for treatment
● African Americans generally underutilize the mental health system
● African Americans less likely than white to find antidepressants acceptable
● “Healthy Cultural Paranoia” which is cultural mistrust that originated during periods of
oppression/racism

10. Communication in the Counseling
Setting:
● African American clients use a communication style that is often “high-key, animated,
heated, interpersonal, and confrontational”
● Prefer more active and direct forms of helping rather than passive, non-directive
communication
● Prefer a more structured and logical approach (ex: an intake information session)
● Can be misperceived on the basis of their nonverbal behavior
● Toughness in coping mechanism: African American elders may be more vocal in
verbalizing feelings contrary to their real feelings or they may be verbally restrained and
not reveal their true feelings

11. Works Cited
http://www.ncbi.nlm.nih.gov/books/NBK44251/
https://store.acponline.org/ebizatpro/images/productimages/books/sample%20chapters/cultural_ch02.
pdf
http://ssrdqst.rfmh.org/cecc/index.php?q=node/8
https://www.questia.com/library/journal/1G1-239813835/attitudes-of-african-american-males-
regarding-counseling
http://cssr.berkeley.edu/research_units/casas/links_details_curricula_ethnicity.html#anchor238319
http://www.thebody.com/content/art30946.html
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241476/
Textbook: Counseling Strategies and Interventions
Textbook: Counseling the Older Adult