Cultural competence in therapy with African Americans

Abstract

African Americans experience unique obstacles when interfacing with mental health services. Evidence of persistent disparities in treatment engagement, utilization, and quality between African Americans and European Americans has led many to conclude that treatment must be culturally tailored for African Americans. Underlying calls for increased cultural competence are assumptions regarding the effectiveness of standard treatment approaches with African Americans and the ubiquitous benefits of cultural tailoring. In this chapter, we critically assess these assumptions and review the empirical literature on treatment outcomes with African Americans and the effects of culturally tailored interventions. Overall, we find that psychotherapy, including standard and culturally tailored treatment, is generally effective with African Americans. Additionally, we show that although cultural tailoring can enhance treatment outcomes, not all forms of tailoring are equally efficacious and some types can even attenuate outcomes. Based on the empirical evidence, we provide recommendations for tailoring treatment and improving the quality of mental health services for African Americans.