A Family Strengths Model of Adjustment to Disability for African American Clients

Sociocultural factors germane to African American families need to be recognized and incorporated into the counseling process of African Americans with disabilities. It is imperative that counseling professionals develop a thorough understanding of the family, community, and cultural ecologies of African Americans who are disabled. This article includes an analysis of the African American family system and its inherent strengths. A family strengths model of adjustment to disability for African American clients is presented, and potential applications of the model to the adjustment process are provided.     

Race-Related Differences in the Experiences of Family Members of Persons with Mental Illness Participating in the NAMI Family to Family Education Program

Families play an important role in the lives of individuals with mental illness. Coping with the strain of shifting roles and multiple challenges of caregiving can have a huge impact. Limited information exists regarding race-related differences in families’ caregiving experiences, their abilities to cope with the mental illness of a loved one, or their interactions with mental health service systems. This study examined race-related differences in the experiences of adults seeking to participate in the National Alliance on Mental Illness Family-to-Family Education Program due to mental illness of a loved one. Participants were 293 White and 107 African American family members who completed measures of problem- and emotion-focused coping, knowledge about mental illness, subjective illness burden, psychological distress, and family functioning. Multiple regression analyses were used to determine race-related differences. African American caregivers reported higher levels of negative caregiving experiences, less knowledge of mental illness, and higher levels of both problem-solving coping and emotion-focused coping, than White caregivers. Mental health programs serving African American families should consider targeting specific strategies to address caregiving challenges, support their use of existing coping mechanisms and support networks, and increase their knowledge of mental illness.     

A Closer Look at Religiosity Among Family Caregivers

This article addresses the relationships between the dimensions of religiosity and positive appraisal of caregiving among African American, Hispanic, and non-Hispanic Caucasian family caregivers for older adults. Data analysis of 69 subjects revealed a negative correlation between non-organizational religiosity and positive appraisal of care among African American caregivers and a positive correlation between organizational religiosity and positive appraisal of care among Hispanic caregivers. Findings from this analysis challenges the overall assumption that religiosity increases positive appraisal of caregiving. Rather, the nature and outcomes of family caregiving are different for various ethnic groups.     

Stress Among African American Emerging Adults: The Role of Family and Cultural Factors

The aim of this study was to examine the effects of family and cultural variables on stress among African American emerging adults. Data from this study was collected as part of a larger study that examined cultural, family, and contextual factors and smoking among African American youth in 5th, 8th, and 12th grades. Data were collected from high school seniors at the end of their 12th grade year and 6 months post high school. Multiple regression analyses were conducted to determine whether racial identity, family cohesion, and parental monitoring influence students’ perceived frequency of stress. Higher levels of racial identity were associated with more perceived stress. There were no significant main effects for either parental monitoring or family cohesion on stress. There were significant interactions between racial identity and parental monitoring and between parental monitoring and family cohesion. Study implications are discussed regarding the importance of stress reduction programs for African American emerging adults and for parents of these adults.     

Family Functioning Assessment in a Community Sample of African American Caregivers and Children

Racial/ethnic minority youth receive approximately half of the mental health services of their non-minority peers. Improved methods for identifying African American families in need of behavioral health services are necessary. The Family Assessment Device and General Functioning subscale have been found to be reliable and able to detect family functioning impairment in a generalized sample, but less is known about the reliability and validity of the assessment with an African American community sample. Data from 53 African American caregiver-child (ages 7–13) dyads was collected including family demographics and the Family Assessment Device General Functioning (FAD_GF) scale. Confirmatory factor analysis was conducted to determine the minimal number of FAD_GF items (12 vs. 6 items) that were valid and reliable. The 12-item FAD_GF and the 6-item scale had acceptable psychometric properties, and the 6-item measure demonstrated improved model fit over the 12-item scale and identified more clinically impaired families (6-item: 28% vs. 12-item: 23%). The 6-item measure of family functioning was more sensitive 12-item FAD_GF. This brief measure may prove useful for identifying and assessing African American families.

     

Direct Observation of Family Management: Validity and Reliability as a Function of Coder Ethnicity and Training

This study examines the influence of coder ethnicity on the validity and reliability of direct observations of family management. Eight coders, 4 European American (EA) and 4 African American (AA), were randomly assigned to conduct behavior ratings of videotaped family interactions of European American and African American families, under two conditions: untrained and trained. Results indicated statistical differences between EA and AA coder ratings of family management practices across both untrained and trained conditions, suggesting the presence of ethnocentric perceptions of coders. Specifically, EA coders tended to rate AA families as exhibiting poorer family management skills compared with those of EA families. AA coder ratings for EA and for AA families showed no statistical differences. Although not statistically significant, posttraining coding results indicated a trend toward decreased differences among coder perceptions, especially in improving the validity and reliability of EA coder ratings of AA families. These findings are discussed with respect to recommendations for cross-cultural research as well as general theories of ethnic socialization.     

Family Therapy with Unmarried African American Mothers and Their Adolescents

Almost two-thirds of African American births are to unmarried mothers, and these single parents are among the most economically vulnerable in the United States. The effects of chronic stressors such as poverty can compromise the ability of these mothers to parent effectively, particularly during the developmental period of adolescence, typically a stressful phase of parenting. This article describes a multidimensional family therapy (MDFT) approach to working with African American adolescents who have drug and/or behavior problems. It is maintained that addressing the intrapersonal functioning of African American single mothers is vital if they are to re-establish the attachment bonds necessary for the maintenance of essential parental influence in the lives of their adolescents. Through systematic attention to the parent as an individual, leading to a balance between self-care and care for others, parental supervision is more easily achieved and relational impasses between parent and adolescent more equitably resolved.     

Family Matters: The Role of Mental Health Stigma and Social Support on Depressive Symptoms and Subsequent Help Seeking Among African American Boys

African American adolescent boys underutilize mental health service due to stigma associated with depression. Gaining an increased understanding of how depressed, African American adolescent boys perceive their mental health needs and engage in help-seeking behaviors might play an essential role in efforts to improve their symptoms and access to care. Using a mixed-methods design, this study examined the influence of mental health stigma and social support on depressive symptoms among African American adolescent boys. Findings indicated the protective effects of social support in decreasing depressive symptoms, especially when participants experienced mental health stigma. Results also revealed the pivotal role of family social support over both professional and peer support for participants who struggled with depressive symptoms. The primacy of family support among the sample, combined with the frequent distrust of professionals and peer networks, would indicate that working with families may improve initial identification of depression among African American adolescent boys and decrease their barriers to care.     

Individual and Family Contributions to Depressive Symptoms in African American Children with Sickle Cell Disease

Depressive disorders in children with chronic illnesses have received little attention despite some evidence suggesting that these children experience increased psychological difficulties as a result of their medical condition. Most of the research on depressive disorders among children has been conducted primarily with Caucasian youth, limiting generalizability to ethnically diverse populations. Further, even less research exists on depressive disorders among African American children with Sickle Cell Disease (SCD) and for African American youth from lower socioeconomic status who are at greater risk for depressive disorders. This paper is an extensive review of the major studies conducted on depression and psychosocial aspects of SCD in African American children. The Transactional Stress and Coping model is provided as a conceptual framework. Following the review, clinical and research implications are provided, as well as an illustration of a psychoeducational family intervention with an African American child who has SCD and internalizing behaviors.     

Examining Relationships Between Ethnic Identity, Family Environment, and Psychological Outcomes for African American Adolescents

Ethnic identity has been linked to a number of healthy psychological outcomes for African American adolescents. The levels of conflict and cohesion in the family environment have also been found to be predictive of adolescent mental health. This study examined whether the ethnic identity and levels of conflict and cohesion in the family environments were related to adolescents’ psychological adjustment. Participants included 61 African American adolescents, ages 10–14 years old, and their parents. Hierarchical regression models were used to determine the cumulative effects of ethnic identity and family functioning on adolescent mental health, specifically adolescent levels of depression, self-esteem, and interpersonal functioning. Results indicated that having a positive ethnic identity and a cohesive family environment were most strongly associated with psychological adjustment. Implications of these results are discussed in terms of family interventions.     

Order in the home: Family routines moderate the impact of financial hardship

The study examined whether frequency of adolescent reported family routines moderated the relation between caregivers' perceptions of financial resources and adolescents' behavioral and academic outcomes among a sample of inner-city African American families. The sample consisted of 115 adolescents (average age = 15.95) and their female caregivers participating in a large scale study on African American family life. The results revealed a significant main effect of financial resources and family routine on adolescent outcomes, such that an increase in both was related to less delinquency and more favorable academic outcomes. Family routines moderated the relation between financial resources and adolescent outcomes. Specifically, the study revealed that the link between lack of financial resources and negative adolescent outcomes was diminished for youth in high-routine homes. Alternatively, family routines did not have a significant impact on youth from high-resource homes. Results highlight the importance of organization and predictability for economically disadvantaged youth and families.     

Family ties: constructing family time in low-income families

"Family time" is reflected in the process of building and fortifying family relationships. Whereas such time, free of obligatory work, school, and family maintenance activities, is purchased by many families using discretionary income, we explore how low-income mothers make time for and give meaning to focused engagement and relationship development with their children within time constraints idiosyncratic to being poor and relying on welfare. Longitudinal ethnographic data from 61 low-income African American, European American, and Latina American mothers were analyzed to understand how mothers construct family time during daily activities such as talking, play, and meals. We also identify unique cultural factors that shape family time for low-income families, such as changing temporal orientations, centrality of television time, and emotional burdens due to poverty. Implications for family therapy are also discussed.     

A Multilevel Contextual Model of Family Conflict and Deviance

This paper presents a multiple-group multivariate hierarchical specification of family problem behaviors across ethnicities using structural equation modeling techniques which explicitly model the individual-level and family-level covariance matrices in familial problem behavior. Analyses were conducted across White and African American ethnic groups. The sample (N = 1,168; 647 White and 521 African Americans) comprised children and their parents from 392 families. In addition to relations between family conflict and deviant behaviors, covariates were included at each level of analysis: neighborhood desirability at the family (between) level, and age and gender at the individual (within) level. At the between level, neighborhood desirability influenced family conflict and family conflict influenced family levels of deviance. At the within level, conflict was significantly related to individual levels of deviance. Discussion focuses on the substantive results as well as the application of multilevel analyses to contextual influences of family problem behavior.     

Family Environment in Inner-City African-American and Latino Parents/Caregivers: A Comparison of the Reliability of Instruments

Inner-city, African American and Latino youth are at higher risk for the development of obesity and type 2 diabetes. Interventions usually focus on changing physical activity and dietary behaviors, yet family environment has the potential to influence response to these interventions. We aimed to identify instruments that could reliably be used to assess the family environment of children from high-risk populations. Selected indices from four instruments were used; the Family Environment Scale (FES), the Family Adaptability and Cohesion Evaluation Scales IV (FACES IV), the Self-report Family Inventory (SFI), and the Family Assessment Device (FAD). Out of 15 indices evaluated, 9 were reliable in both ethnicities including FES cohesion, conflict and organization, SFI emotional expressiveness, conflict and family health/competence, FACES IV family communication and family satisfaction, and FAD general functioning. Perceived family environment characteristics did not differ significantly for inner-city African American and Hispanic families.     

Family and Contextual Predictors of Depressive Symptoms in Inner-City African American Youth

Family and contextual predictors of depression in inner-city, African American youth have rarely been examined. In this study we explore the contribution of current and historical life events, family conflict, perceived social support from mother, maternal depression, and maternal explanatory style to the depressive symptoms of inner-city African American school-age (M = 10.7 years) children. Home interviews were conducted with 89 mother and child dyads living in moderate- to high-violent areas of a southeastern city. Regression analyses revealed that the children in this sample with higher levels of depressive symptoms had higher levels of child-reported everyday stress, were more likely to have been abused at some point in their past, came from homes with mothers who were less well educated, and had mothers who reported higher levels of depression, a past history of domestic abuse, as well as a less pessimistic explanatory style. Implications for interventions with inner-city African American families are discussed.     

Social Support from Family and Friends and Subjective Well-Being of Older African Americans

This study examines the impact of informal social support from family and friends on the well-being of older African Americans. Analyses are based on a nationally representative sample of older African Americans from the National Survey of American Life (n = 837). Three measures of well-being are examined: life satisfaction, happiness and self-esteem. The social support variables include frequency of contact with family and friends, subjective closeness with family and friends, and negative interactions with family. Results indicate that family contact is positively correlated with life satisfaction. Subjective closeness with family is associated with life satisfaction and happiness and both subjective closeness with friends and negative interaction with family are associated with happiness and self-esteem. There are also significant interactions between family closeness and family contact for life satisfaction, as well as friendship closeness and negative interaction with family for happiness. Overall, our study finds that family and friend relationships make unique contributions to the well-being of older African Americans. Qualitative aspects of family and friend support networks (i.e., subjective closeness, negative interactions) are more important than are structural aspects (i.e., frequency of contact). Our analysis verify that relationships with family members can both enhance and be detrimental to well-being. The findings are discussed in relation to prior research on social support and negative interaction and their unique associations with well-being among older African Americans.     

The Protective Role of the Family and Social Support Network in a Sample of HIV-Positive African American Women: Results of a Pilot Study

This study examined the role of family functioning and social support in protecting HIV-positive African American women from the adverse psychological consequences associated with deterioration in their CD4 cell count. Participants were 38 African American HIV-positive women who had recently given birth. Results demonstrated that changes in CD4 cell counts were inversely predictive of psychological distress and were moderated by family functioning and social support satisfaction. Women with good family functioning were less affected by changes in their CD4 cell counts, and women with poor family functioning were more emotionally responsive to changes in CD4 cell count. Unexpectedly, women from families where conflicts tended to be clearly laid out and discussed were also more responsive to both changes in CD4 cell counts. Interventions are recommended that increase a client's social support satisfaction, foster an adaptive level of connectedness to family, and enhance the family's range of conflict resolution styles.     

The Relationship Between Family Stress and Behavioral Health Among African American Adolescents

African American youth, especially those who live in low-income communities, are at increased risk for experiencing higher juvenile justice involvement, poorer mental health, low school engagement, higher illicit drug use, and STIs, relative to their higher income peers and those from other ethnic backgrounds. However, few studies have examined the relationship between family stressors and these multiple youth concerns. This study examines the relationship between family stress (i.e., having an adult in the home with a history of mental illness, substance use, and incarceration) and youth concerns such as substance use, mental health challenges, low school engagement, juvenile justice involvement, and STI risk behaviors. A total of 638 African American adolescents living in predominantly low-income, urban communities participated in the study by completing self-report measures on the above constructs. Logistic regressions controlling for age, gender, socioeconomic status, and sexual orientation indicated that adolescents who reported higher rates of family stress were significantly more likely to report mental health problems, delinquent behaviors, juvenile justice involvement, drug use, risky sex, and lower school engagement factors. Findings suggest that attending to the developmental concerns of youth also requires addressing the needs of the family unit.     

Family,peer, and neighborhood influences on academic achievement among African-American adolescents: One-year prospective effects

Using a 1-year prospective design, this study examined the influence of family status variables (family income, parental education, family structure), parenting variables (maternal support and restrictive control), peer support, and neighborhood risk on the school performance of 120 African American junior high school students. In addition to main effects of these variables, neighborhood risk was examined as a moderator of the effects of parenting and peer support. Family status variables were not predictive of adolescent school performance as indexed by self-reported grade point average. Maternal support at Time 1 was prospectively related to adolescent grades at Time 2. Neighborhood risk was related to lower grades, while peer support predicted better grades in the prospective analyses. Neighborhood risk also moderated the effects of maternal restrictive control and peer support on adolescent grades in prospective analyses. These findings highlight the importance of an ecological approach to the problem of academic underachievement within the African American community.     

Rock: An Unlikely Metaphor for Spirituality,Family Therapy,Mental Health and Illness

This article brings together fragments of a conceptual scheme and a number of big ideas: religious faith, contexts of African American spirituality, mental health and illness; and family therapy and the extended metaphor of sedimentary rock formation. Religion and spirituality are used somewhat interchangeably in this essay to signify embodied spirituality and sacred unity. The rock metaphor captures the idea of multiple entities that, like layers of sedimentary rock, make up families and communities and provide cohesion and a connection with the past. The rock metaphor captures the quality of hardness that may have either a positive of negative meaning and that allows for resilience in the face of adversity. Both qualities can be found in African American spirituality and Black churches. Both qualities have a relationship with the numinous. The qualities of the rock and their relationship with the numinous offer family therapists’ new insights and ways to think about how to approach a clinical presentation.