A Narrative Approach to Child and Family Therapy in Africa*

Professional family therapy in Africa is heavily influenced by theories and principles of Western family practice. Its practice structure and philosophies are however grounded on African family values and the principles and orientations of traditional African psychology. This paper presents a clinical report that illustrates adaptations we make to incorporate compatible aspects of narrative family practice in African and Western cultures. A summary of African family values and child psychology intended as a background perspective is provided. The paper is significant against the background of the current need for forging multiculturally relevant healing methods that fit well with the globalized nature of the contemporary world. Augustine Nwoye, PhD, is Associate Professor and Chairman, Department of Psychology, Kenyatta University, Nairobi, Kenya (amnwoye@avu.org). Professor. Nwoye has developed an African paradigm for mental health and, in particular, for family and couple therapy. He also has experience in dealing with stress and multiple losses, especially surrounding HIV/AIDS within an African context. *An earlier version of the paper was presented to the members of staff and students of the Faculty of Education, University of Cambridge, England, UK, and the initial version was presented to the members of the Family Therapy Program of the Faculty of Medicine of the University of Calgary, Calgary, Canada. I wish to thank Dr. Colleen McLaughlin (University of Cambridge) and Professor Karl Tomm (University of Calgary) for their invitation, assistance, time, attention, and suggestions.     

Mother-Adolescent Relationship Quality and Autonomy as Predictors of Psychosocial Adjustment Among African American Adolescents

This study investigated the role of mother-adolescent relationship quality and autonomy in the psychosocial outcomes in a sample of African American adolescents drawn from the National Longitudinal Study of Adolescent Health. The results indicated that positive mother-adolescent relationship quality and greater autonomy were associated with higher self-esteem, fewer depressive symptoms, and less delinquent behavior. Moreover, adolescents who were older, female, or from households with less income reported more depressive symptoms. In addition, adolescents who were younger or female reported fewer delinquent behaviors. Being male was associated with higher self-esteem. Adolescents’ age, family income, and mother-adolescent relationship quality did not moderate relations between autonomy and the outcome variables.     

Treatment Seeking for Anxiety and Depression Among Black Adults: A Multilevel and Empirically Informed Psycho-Sociocultural Model

Black adults with anxiety and/or depressive disorders underutilize outpatient psychotherapy and pharmacological treatment compared to White adults. Notably, anxiety and depressive disorders tend to be chronic and Black individuals with these disorders experience greater functional impairment than White individuals. Documented racial disparities in mental health treatment initiation indicate a need for research that addresses culture-specific barriers to treatment. This review paper critically evaluates existing theoretical models of treatment seeking among Black adults to inform a novel integrated, culturally contextualized model. This model extends previous ones by incorporating factors relevant to treatment seeking among Black adults (e.g., racial identity, perceived discrimination, medical mistrust) and critically examines how these factors intersect with key factors at three levels of influence of the treatment seeking process: the individual level, the community level, and the societal level. We posit interactions among factors at the three levels of influence and how these may impact treatment seeking decisions among Black adults. This model informs suggestions for enhancing interventions designed to support outpatient service use among Black adults.     

The Effects of Images of African American Women in Hip Hop on Early Adolescents’ Attitudes Toward Physical Attractiveness and Interpersonal Relationships

This qualitative study was designed to identify African American early adolescents’ subjective meanings of African American women’s sexuality through an examination of Stephens & Phillips (2003) sexual images—the Diva, Gold Digger, Freak, Dyke, Gangster Bitch, Sister Savior, Earth Mother, and Baby Mama. These eight sexual images both inform and reflect beliefs about African American women’s physical attractiveness. Interpersonal relationship decision making processes also were influenced by these conceptual frameworks of African American women’s sexuality. Findings from this study are important given the tendency of previous researchers to ignore race and intraethnic variations in studies of beliefs about attitudes toward sexuality.     

Using Adult Learning Theory Concepts to Address Barriers to Cancer Genetic Risk Assessment in the African American Community

Utilization of cancer genetic risk assessment can be profoundly influenced by an individuals’ knowledge of risk assessment, attitudes regarding illness and healthcare, and affective reactions derived from social norms. Race and ethnicity play a powerful role in the development of an individual's attitudes and should be considered when attempting to understand a person's openness to cancer genetic risk assessment (Lannin et al., 1998). Until recently, however, cancer screening and prevention programs have been primarily based on data from studies conducted with the Caucasian population, yielding data that are not fully applicable to the African American community. In the last several years, research findings regarding African American's knowledge, attitudes, and feelings about genetic counseling and testing have grown (Matthews et al., 2000; Singer et al., 2004; Thompson et al., 2003). However, to the authors’ knowledge, these data have yet to be presented in a manner that both summarizes the barriers that African Americans have reported regarding cancer genetic risk assessment, while at the same time suggesting methods individual genetic counselors can utilize during community presentations to help address these barriers. This article will first summarize previous empirical findings regarding African Americans’ knowledge, attitudes, and feelings about cancer genetic risk assessment. The article will then apply adult learning theory to those findings to provide genetic counselors with practical, theory based techniques to apply toward community based educational programs with African American groups.     

Unfair treatment and self-regulatory focus

Ample correlational evidence exists that perceived unfair treatment is negatively related to well-being, health, and goal striving but the underlying process is unclear. We hypothesized that effects are due in part to contextual priming of prevention focus and the negative consequences of chronic prevention-focused vigilance. Indeed, reasonable responses to unfair treatment—to avoid situations in which it occurs or if this is not possible, confront it head on—fit prevention self-regulatory focus response patterns. Results from three experiments support this notion. Priming stigmatized social category membership heightened students’ prevention (not promotion) focus (n = 117). Priming non-stigmatized social category membership (i.e., white) did not change prevention focus (n = 46). Priming prevention (not promotion) increased perceptions of unfair treatment (and aroused prevention-relevant fight or flight responses) in response to a negative ambiguous job situation among low and moderate income adults (n = 112).     

Dangerous love in mythical narratives and formula tales

The theme of love has long been neglected in studies on African myths. The often-heard explanation is that African myths and folktales do not tell stories about love because they primarily express social interests and obligations while love – intended as both emotional imperative and biological drive – is an individual need and feeling. This latter definition relies on a very specific understanding of ‘love’: the Romantic love of 19th century European novels. This paper argues that when love means attraction, affection, passion, and necessity, it turns up as liaisons dangereuses in many African narratives. Love becomes a driving force that generates gender constructions by reinforcing the unity of the couple or by fuelling the struggle between partners.In the case of Kabyle narratives (Algeria),¹ conceptualisations of love as well as the relationships between myths and folktales are explored by analyzing formula tales² and the only known collection of Kabyle Berber myths: those collected by Leo Frobenius, ethnologist and historian of religion, at the beginning of the 20th century and published in the first volume of his Volksmärchen der Kabylen in 1921.The discussion of the relationship between Kabyle myths and folktales touches upon a well-known interpretative problem in the study of religion: the articulation of myth and ritual with history as communities respond to sweeping social, political, and religious changes, such as the coming of Islam, colonization, decolonization, and globalization.     

The Social Production of Altruism: Motivations for Caring Action in a Low-Income Urban Community

Contemporary social science paints a bleak picture of inner-city relational life. Indeed, the relationships of low-income, urban-residing Americans are represented as rife with distress, violence and family disruption. At present, no body of social scientific work systematically examines the factors that promote loving or selfless interactions among low-income, inner-city American individuals, families and communities. In an effort to fill that gap, this ethnographic study examined the motivations for altruism among a sample of adults (n = 40) who reside in an economically distressed housing community (i.e., housing project) in New York City. Content analyses of interviews indicated that participants attributed altruism to an interplay between 14 motives that were then ordered into four overarching categories of motives: (1) needs-centered motives, (2) norm-based motives deriving from religious/spiritual ideology, relationships and personal factors, (3) abstract motives (e.g., humanism), and (4) sociopolitical factors. The implications of these findings are discussed.     

Community-Based Interventions to Reduce Low Income, African American Women's Risk of Sexually Transmitted Diseases: A Randomized Controlled Trial of Three Theoretical Models

A community-based sample of disadvantaged African American women (n = 445) was recruited to participate in 1 of 3 theoretically driven experimental interventions based on either the theory of gender and power, social learning theory, or cognitive behavioral theory. Intervention outcomes were compared with a waiting list control condition. From baseline to postintervention, women in the experimental interventions showed differential change on cognitive indices (knowledge and attitudes) and skill acquisition (partner negotiation skills, correct condom application, lubricant selection, and information-provision to social networks) whereas control participants were unchanged. Women in the 3 experimental interventions also completed follow-up assessments for 1 year following the interventions. In all 3 experimental conditions, condom use increased relative to the control group and there were no differences between the experimental interventions. Women who participated in one of the theoretically grounded interventions continued to increase condom use over the following year. Women entering new relationships reported significantly more condom use than did women who remained in ongoing relationships. The findings suggest that intervention models that have proven effective for women who engage in high-risk behavior may be less effective for women in established relationships for whom risk is primarily derived from the extrarelationship behavior of their partners.