Abstract
This paper identifies the prevalence, correlates, and negative implications of substance abuse among African American women. Several efforts have been devised to prevent substance abuse but family therapy has been effective especially when it is designed to be culturally sensitive. Several complex issues and limitations have also been cited in the programs that are used for the African American community. These issues are because the treatment is applied to individuals from diverse backgrounds.
Approximately one-third of the American population is affiliated with a minority group either by ethnicity or race. Culture is very significant in the treatment of substance abuse problems because the patients’ experiences of culture come first and they have great implications on their clinical experience.
The styles of coping, stigmatization, social support, and settings of treatment that are related to substance abuse are influenced by culture. It’s pertinent therefore to understand culture as a very wide concept affecting a group of people in terms of their shared norms, beliefs, and values based on ethnicity and identity affiliations.
Introduction
Family-centered treatment is an all-inclusive approach that deals with the biological, psychological, social, and spiritual nature of substance abuse behavior. The approach is often highly individualized and genders sensitive especially when addressing this problem among women. The gender-sensitive aspect is predicated on the distinguishing characteristics that are evident in the women’s physiology, experiences, socialization, culture, and relative statuses.
This treatment is focused on treatment that is designed around maintaining affiliations and developing healthy relationships with other people particularly the family members and children to be specific.
The family-centered treatment offers a full range of benefits that address several problems that women with substance abuse behavior face, their children, and other family members as well. A mother diagnosed with substance abuse is the main client of the family-centered treatment approach together with her children and other members of the family as her co-clients. Women who get into the program of family-centered therapy show a high likelihood of taking responsibility.
There are, however, some few families that have fathers as the primary caretakers and hence the main clients of the family-centered treatments but these are uncharacteristic.
African-American Statistics
The African Americans comprise 13% of the American population and this community is very diverse in it comprises people from different regions of the world like the Caribbean, African Canada, and Bermuda (McKinnon, 2003, p. 27). This group of people has also shared a history of slavery, segregation, and some form of racism that is institutionalized. African Americans differ from other communities in American in terms of social statuses, culture, way of life, self-perception, aspirations, and heredity.
The Office of Applied Studies- NHSDA (2003) reported that in 2000, about 34% of the African Americans were consumers of alcohol from age 12 and above, the white had a 51 percentage and Hispanic and Latinos had a percentage of 40. On the other hand, 6% of the African-Americans used illicit substances same as the whites.
Africa Americans that are being admitted to substance abuse treatment comprise 24% of admissions and out of those that were perceived to need help, 25% of them had unmet needs (Office of Applied Studies NHSDA, 2003). This was at twice the number of whites with unmet needs.
Family-Centered Therapy for African American Women
The primary goal for employing family-centered therapy for women suffering from substance abuse problems, their children, and other close family members is to improve their outcomes (Stewart, 2004, P. 219). To achieve this goal, the program should have a strong structure that comprises interventions, a model of approaches, and efficient services that will help to reach and retain women (Werner et al, 2007, p. 13).
This will be a gender-responsive program that will take into consideration the needs specific to women in all aspects. In comprehensive models, offering clinical therapy include services that are relevant to addressing medical and biopsychosocial concerns that are related to addiction (Werner et al, 2007, p. 16). These services include detoxification, screening, treatment plan, intervening crises, counseling and education, drug monitoring, medication, and continued care.
The support services include employment readiness services, life skills, parenting skills, and recovery of community support services. There are three types of family-centered approaches; parenting and family skills training, family in-home support, and family therapy (Werner et al, 2007, p. 30).
The named approaches target the dynamism of the entire family in the community instead of individuals. The approaches also address the known risk and protective factors that could reduce the chances of women beginning and continuing to abuse substances (Stewart, 2004, P. 219). There are several approaches besides the three in this paper. However, these three have a common basic logic as below
Parenting and family skills training: the family structure, it’s functioning and values have a great impact on the ability of children to develop prosocial skills and cope with the challenges they face in life. When parents are a trend on better skills of parenting and handling family issues, they are in better positions of nurturing and protecting their children and helping them develop prosocial character (Stewart, 2004, P. 221). Parents can deal with challenging children as well. This approach is used for families with children at high risk of exposure to substance abuse.
Family in-home support: this approach targets families at greater risk of abuse because of the many risk factors or open exposure to risk factors. This family would find preventative measures very appropriate. Such families could have children placed outside the home because they are falling apart.
The in-home support takes into account the risks involved simultaneously and develops interventions to the unique family needs (Stewart, 2004, P. 221). The goal of this approach is to reduce chances of domestic violence, neglect, child abuse and prevent extreme measures like placing children in foster homes or juvenile delinquent facilities.
Family Therapy: this approach focuses on the families at greater risk because of multiple risk factors or greater exposure to a certain risk factor. The intervention here is set to enhance family functioning and decrease juvenile delinquency, crime, parents abusing children, and recidivism among other antisocial conducts (Stewart, 2004, p. 223). The family members are in a better position of developing better interpersonal skills, improving communication, and dealing with intricate family dynamics.
This reduces negative behaviors and improves perception towards each other and created an environment for family interaction. Parenting skills are improved and there is no inappropriate control over children.
Continuum of Family-Centered Therapy
There are five progressive steps (Werner et al, 2007, p. 5) involved where family-based services are provided:
- Step 1: treating of women with family involvement – this treatment plan addresses family matters and the goal is to enhance the outcome by involving the family
- Step 2: Treat mother with children involved – the children are included in child care but are not given therapeutic services. The goal is to enhance women results still
- Step 3: treating women and children – both the women and their children have treatment plans and are provided with relevant therapeutic services to enhance results and improve parenting skills (Werner et al, 2007, p. 5)
- Step 4: family services – children are involved in therapy and other services are extended to the rest of the family members. The objective is to enhance the results of children and women and improve parenting skills (Werner et al, 2007, p. 5).
- Step 5: family-centered treatment – the service providers develop treatment plans for every family member where each of them is treated individually and then as a family collectively. The goal is to enhance children’s outcomes, improve parenting skills, and better family functioning (Werner et al, 2007, p. 5).
Women’s ego development is based on making and maintaining associations, however, substance use disrupted this and this therapy seeks to establish harmony to recover healthy family functioning. The approach can mitigate individual and family risk factors (Werner et al, 2007, p. 5).
Conclusion
This family-centered approach for African American women has two main advantages. First, their substance abuse, dependence, and successful intervention have a strong relationship with family, particularly the children. The family also influences treatment and relapse, however, the second advantage is that about 70% of the African Americans entering interventions programs have children. This means that the children have a greater risk of child neglect, developmental challenges, and exposure to adolescent substance abuse.
The therapeutic care that would improve parenting skills, the prognosis of the condition, and the outcomes are very beneficial in protecting the children. If the entire family is treated, the outcomes of each member are improved and simultaneously enhance communication and coordination of adult members and their ability to support each other hence the family is healed.
Reference List
McKinnon, J. (2003). The Black Population in the United States: March 2002. Current Population Reports. Washington, DC: U.S. Census Bureau, p. 20–541.
Office of Applied Studies, Substance Abuse and Mental Health Services Administration (2003). The NHSDA Report: Children Living With Substance-Abusing or Substance-Dependent Parents. Web.
Stewart, P.E. (2004). Afrocentric Approaches to Working with African American Families. Families in Society 85(2):217–224.
Werner, D., Young, N.K., Dennis, K, & Amatetti, S. (2007). Family-Centered Treatment for Women with Substance Use Disorders – History, Key Elements and Challenges. Rockville: Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA).