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A PSYCHOLOGICAL PROSPECTIVE: UNDERSTANDING THE BLACK VIEW ON PSYCHOLOGICAL SERVICES AND SPIRITUALALITY Doctoral Dissertation Research Submitted to the Graduate Faculty of Argosy University, Los Angeles College of Behavioral Sciences for Counseling Psychology In Partial Fulfillment of the Requirements for the Degree of Doctor of Education Counseling Psychology By Shalanda Kangethe

Doctoral Dissertation Research

April 2018

ii A PSYCHOLOGICAL PROSPECTIVE: UNDERSTANDING THE BLACK VIEW ON PSYCHOLOGICAL SERVICES AND SPIRITUALALITY

Copyright ©2018

Shalanda Kangethe-Chaney

All rights reserved

iii A PSYCHOLOGICAL PROSPECTIVE: UNDERSTANDING THE BLACK VIEW ON PSYCHOLOGICAL SERVICES AND SPIRITUALALITY Doctoral Dissertation Research Submitted to the Graduate Faculty of Argosy University, Los Angeles College of Behavioral Sciences for Counseling Psychology In Partial Fulfillment of the Requirements for the Degree of Doctor of Education Counseling Psychology By Shalanda Kangethe

Dissertation Committee Approval:

iv ABSTRACT The primary aim of the mixed-method study is to expand awareness of an undeserved and studied population in hopes to shed awareness as to why this population has a fear in seeking or reduced retention rate in psychological services. This study was carried out on 22 Black American bible believers that adhere to the “Sola Scriptura (Latin ablative, “by scripture alone”) (Mathison, 2001).” The results of the research of the study focuses on 6 research questions: RQ1) What psychological needs that are not being served for Black Americans; RQ2) What are the discriminatory practices used in psychology (Assessments, Therapy/ Theory, and Interventions); RQ 3) Are Current psychotherapy practices not effective with the Black Americans due to not being biblically based; RQ 4) What are the best culturally congruent treatment modalities for the Black Americans; RQ 5) What are the most effective biblically based theories utilized to provide psychotherapy to Black Americans; RQ6) What participant characteristics are undesirable and desirable in achieving increased retention and sought out services psychological care. The analysis of both qualitative and quantitative data revealed that the level of decision making of the particpants is influenced by their spiritual needs and that the needs negatively impact on their propensity to seek psychological services. In conclusion, future research should be geared towards the development of culturally congruent intervention model targeted to this community.

v ACKNOWLEDGEMENTS I would like to Acknowledge the Most High Yah (Eeyah) for directing me step by step through the process of completing this research. I’m truly grateful for the revelation of true heritage of the so called Black/African Americans, and the platform to share with those that may not have known. When one has no legacy, or history to identify with is like a tree without roots. I would also like to Acknowledge my three children Shaquille Smith, Za’Kia Smith, and J’son Kangethe. Thanks for pushing me, speaking words of life and truth, and allowing me to cry on your shoulders. I love you so much, and all of this is having always been about creating a better life for you. In addition to being able to make sure you had the best example of a mother I could be. I would also would like to Acknowledge Dr. Joy Shabandar for encouraging, being a counselor, cracking the whip, supporting, allowing me to cry and not give up, and being the strong woman of God He has called you to be. I love you, I’m so glad and thankful the previous Chair dropped the ball. Lastly, to the hardest working woman I know Dr. Irma Gibson. I thank you for being more than a mentor. You are the woman I aspire to be, you are a light in the Black community and a true gift to the educational system. I pray that the Most High continue to open doors for you impact our community the way you have and continue to do.

vi DEDICATION I would like to dedicate this research to all my ancestors that fought escape, read, pray, conversion, rap, and to live just so that I can have the opportunity to tell a fragment of their history. My three children that had to be without me at times, and never complained one day about it. To my father who listened and supported me financially when times get ruff. To my mother, sisters, brother, nieces, and family I love you all more than you know. Lastly, I would also like to dedicate this to one of the most amazing man I have ever meet in my life. You are truly a breath of fresh air, and the best example of a righteous man sent by the Most High. For that I’m grateful to have meet you in such an interesting time in my life.

vii TABLE OF CONTENTS Page viii

LIST OF TABLES .............................................................................................................x LIST OF FIGURES ......................................................................................................... xi LIST OF APPENDICES ................................................................................................ xii CHAPTER ONE: INTRODUCTION ..............................................................................1 Problem Background ........................................................................................................ 1 Purpose of the Study ......................................................................................................... 3 Research Questions, and Hypotheses .............................................................................. 5 Definitions .......................................................................................................................... 6 Significance of the Study .................................................................................................. 7 Initial Review of Literature.............................................................................................. 9 Proposed Sample (Participants) .................................................................................... 13 Description of Data Analysis Procedures ..................................................................... 15 Conclusion ........................................................................................................................16 CHAPTER TWO: HISTORY, RACE AND REVIEW OF THE LITERATURE ...17 Introduction ..................................................................................................................... 17 History .............................................................................................................................. 19 The Purpose of Creating Races ..................................................................................... 22 Race Reclaassification ............................................................................................ 23

viii Review of the Literature ................................................................................................. 24 The Black American Community and Psychology .............................................. 24 What Psychological Needs not Neing Servered for Black Americans................ 25 What are the Best Culturally Congruent Treatment Modalities for Black Americans ................................................................................................................ 28 Black American Psychology and the Church ....................................................... 29 Culturaally congruent treatment modalities for Black Americans .................... 32 What are the Most effective Bibically Based Theories Utilized to Provide Psychotherapy to Black Americans ....................................................................... 32 Have Black Americans Lost Their Identity as a Result of Assimilation with the Majority Culture, European Americns ................................................................. 33 How does the Culturally Congruent Modalities line up with Biblical Doctrine 33 Summary .......................................................................................................................... 34 CHAPTER THREE: METHODOLOGY .....................................................................35 Restatement of the Purpose............................................................................................ 35 Research Questions & Hypotises ................................................................................... 35 Research Design .............................................................................................................. 36 Subjects or Setting .................................................................................................. 36 Instrumentation or Intervention ........................................................................... 37 Process or Procedures ............................................................................................. 37 Methodological assumptions, limitations, and delimitations .............................. 37 Methodological assumptions .......................................................................... 37 Limitations ....................................................................................................... 40

ix Delimitations.................................................................................................... 41 Data Processing and Analysis ........................................................................................ 44 Conclution........................................................................................................................ 45 CHAPTER FOUR: RESULTS ...................................................................................... 46 Restatement of the Purpose............................................................................................ 46 Organization and Presentation ...................................................................................... 47 Tables ....................................................................................................................... 50 In-text Placement ............................................................................................ 50 Summary .......................................................................................................................... 62 CHAPTER FIVE: DISCUSSION, CONCLUSIONS, AND RECOMMENDATIONS ............................................................................................................................................63 Discussion......................................................................................................................... 63 Conclusions ...................................................................................................................... 65 Implications for Practice ................................................................................................ 66 Recommendations for Further Research...................................................................... 67 REFERENCES .................................................................................................................69

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x LIST OF TABLES Page 81 Table 1. Age Distribution Table ................................................................................... 81 Table 2. Relationship Status.......................................................................................... 81 Table 3. Education of Participants. .............................................................................. 82 Table 4. Income Data ..................................................................................................... 82 Table 5. Why Some Needs of the African Americans Cannot be Met Through Psychotherapy ................................................................................................................. 83 Table 6. Relationship Status.......................................................................................... 84 Table 7. The Importance of Understanding the History of Psychology Before Agreeing to Services ........................................................................................................ 85

xi LIST OF FIGURES Page 21 Figure 1. Negroland and Guina .................................................................................... 86

xii Page 80 Appendix A. Consent Form .......................................................................................... 87 Appendix B. Informed Concent .................................................................................... 90 Appendix C. Demographic Questionnaire ................................................................... 93 Appendix D. Exclution Criteria Survey ....................................................................... 95 Appendix E. Quantitative Survey ................................................................................. 97 Appendix F. Flyer .......................................................................................................... 99 Appendix G. Recruitment Email ................................................................................ 101 Appendix H. Study Debrefing..................................................................................... 103 Appendix I. Certificate of Particpation ..................................................................... 105

1 CHAPTER ONE: INTRODUCTION If one is to consider the cultural relativity of psychology alone, one must agree that there is a bias regarding any culture outside of the European race (D. Suite, 2007). Many scholars have written about the historical foundations and expected consequences of Black Americans distrust in the mental health system (Jacobs, 2006). Yet, little research has been done to understand how this distrust impacts Black Americans' current views of the trustworthiness of psychotherapists (Jacobs, 2006). The Surgeon General’s report on culture and mental health (2001) also strongly suggest that cultural communication problems between clients and psychotherapists may prevent minority group members from using services and receiving appropriate care. Crosby (2007) reveals that the availability and suitability of such services for people of color is poor and dissatisfactions are experienced by both clients and psychotherapist in their therapeutic encounters. Though there are many services available for those who are seeking assistance for mental health issues, they are not readily sought after by people of color. Problem Background The mistrust in the mental health care system leads to an underutilization of mental health services by the Black American community (Suite, 2007). The Center for Disease Control reported in (2011) 18.8 % of black adults 18 years or older sought mental health treatment which was 1.7% less than Whites and 10.1% less than Native and Alaskan Americans. Terrell and Terrell (1981), defines cultural mistrust as the degree to which Blacks mistrust Whites. Per Thompson (2004) there are several factors that obstruct Black Americans from seeking Professional counseling. Those factors are: lack of knowledge, lack of financial resources, impersonal service, cultural incompetence, distrust, and stigma

2 (Thompson, Amatea, & Thompson, 2014). Unfortunately, there is a literature gap on empirical research regarding the influence of spirituality and religiosity, independently on psychological well-being in general and notably less among Blacks (Reed, 2014). Given the harsh and unfair treatment of African Americans in the United States, their traditions and experiences have shaped their trust and perceptions about the mental health care system. Dr. Benjamin Rush who is acknowledged as the Father of American Psychiatry, the Dean of the Medical School at the University of Pennsylvania, a signer of the Declaration of Independence, diagnosed Negros with the term Negritude, which is defined as a mild form of leprosy (Rush, 1799). The cure for the disorder was to become white. In 1851, a prominent Louisiana physician and one of the leading authorities of his time Dr. Samuel Cartwright, identified two mental disorders peculiar to slaves (Cartwright, 1836). One is Drapetomania, a disorder that caused Negros to run away (Cartwright, 1836). The cure for the Slaves showing developing drapetomania was to be whipped-strictly as a therapeutic early intervention (Cartwright, 1836). Generally, Dr. Cartwright suggested that Negroes should be kept in a submissive state and treated like children (Cartwright, 1836). Another factor is the historical conflict between psychology and Christianity (Hill, 2006). There is no contesting the founding fathers’ view on organized religion (Reed, 2014). Professor Wilhelm Wundt who established the first “experimental psychology” laboratory in Leipzig University stated that the soul can no longer exist in the face of our present-day physiological knowledge (Wundt,1912, p.192). Ivan Pavlov stated that “Humans saved themselves by creating religion, which enabled them to maintain themselves somehow, to survive in the midst of an uncompromising, all-powerful nature; It is very basic instinct that is throughly rooted in human nature (Windholz, 1986, p. 322).”

3 Though the origins of psychology meant the study of the soul – psyche (soul) and ology (study of) (Liddell, 1996; p.568), the thought that the mind and the body were separate; collective reflection of the triune being mind, body and spirit. The notion of a spirit being, which was a belief that was held by an enormous percentage of civilized man, had no place in naturalistic science (Holliday, 2009). The continued pursuit of psychology along the traditional view would dissconect it from science (Scott, 2003). This type of whitewashing is also a large componet of alienation in the christian church (Reed, 2014). The use of the term whitewash was often a deseptive tool to manipulate historical facts, means employed to conceal mistakes or faults, or attempts to clear reputations by concealing facts (Inwood, 2008). Lastly, the dissconnection of cultural heritage is another factor one must include when viewing this particular culture (Shaw, 2007). Striped of their cultural heritage and the whitewashing of historical events has been a persistent reminder of non-accptance of the Black American race in this country (J. Haviser, 2006). Purpose of the Study The purpose of this mixed-method study is to expand awareness of an undeserved and studied population in hopes to shed awareness as to why this population has a fear in seeking or reduced retention rate in psychological services. The hypothesis of this study is with the use of Biblical Principals alone within Psychological Treatment well impact the probability of effective treatment and increase the retention of this population. This mixed method approaches this researcher will be using is ethnography, because the specific research will be based on why African American Christians chose not to attend psychotherapy, and if the incorporation of biblical principals in their therapeutic process may change their perspective of psychotherapy.

4 This study is seeking to determine how the use of culturally congruent mental health treatment modalities and practices will be effective in retaining Black Americans that hold fast to their traditional beliefs. Through quantitative research this study seeks to test the effectiveness of therapeutic approaches that adhere to the biblical doctrine (Drake, 2001). Instead of seeking services from mental health professionals, the Black American community often turn to the church to satisfy its mental health needs (Scott, Cutural Orientation and Coping with Perceived Discrimination Among African American Youth, 2003). Rubin (1994) notes that, “African Americans have been taught to go to the church for healing of the mind, body, and soul” (p.251). Rubin (1994) goes on to state that “Although the church is not viewed as traditional therapy in the world of medicine, the church has always been viewed as a place of healing (pg. 251).” Hence, in their community the Black American Christian church serves many roles (Watlington, 2006). These roles include being a place of refuge and worship, an institution of education (especially in the history of African American community), and a source of support during emotionally challenging times (Awosan, 2011). Unfortunately, not all churches can meet the needs of individuals in severe emotional and psychological distress (Suite, 2007). In these instances, seeking assistance from mental health agencies would be most helpful. Still, in the Black American culture, the thought of talking to someone other than God is considered taboo (Whaley, 2001). The psychological discipline itself is a threat to the way of living as a Christian (Holliday, 2009). These thoughts need to be explored to determine if psychology is truly a threat to living per the biblical principles. Research Questions and Hypotheses Research Questions 1: What psychological needs that are not being served for Black Americans?

5 Research Questions 2: What are the discriminatory practices used in psychology (Assessments, Therapy/ Theory, and Interventions)? Research Questions 3: Are Current psychotherapy practices not effective with the Black Americans due to not being biblically based? Research Questions 4: What are the best culturally congruent treatment modalities for the Black Americans? Research Questions 5: What are the most effective biblically based theories utilized to provide psychotherapy to Black Americans? Hypotheses (H): H1) The Participant’s level of decision making will be positively associated with their spiritual needs; H2) Participant’s spiritual needs will negatively impact their need to seek psychological services. Definition of Terms Psychology - Study of the soul (Liddell, Scott, Stuart-Jones, & McKenzie, 1996). Whitewashing – is a metaphor meaning "to gloss over or cover up vices, crimes or scandals or to exonerate by means of a perfunctory investigation or through biased presentation of data (Inwood, 2008). Negritude - a mild form of leprosy (Rush, 1799) Drapetomania - a disorder that caused Negros to run away (Rush, 1799) Oppression - the state of being subject to unjust treatment or control Racism - the belief that all members of each race possess characteristics or abilities specific to that race, especially to distinguish it as inferior or superior to another race or races (D. Suite, 2007). Whites or (white Americans) – a racial classification, typically designating the European ancestry or the Caucasian race. The contemporary usage of “white people” or a “white race” as a large

6 group of (mainly European) populations contrasting with “black,” native American, “colored” or non-white which originates in the 17th century (Holliday, 2009). Blacks – is a term used in certain countries, often in socially based systems of racial classification or of ethnicity, to describe persons who are perceived to be dark-skinned compared to other given populations. For some individuals, communities, and countries, “black” is also perceived as derogatory, outdated, or otherwise unrepresented label, and thus is neither used nor defined (Liberman, 2008). Americans – are citizens of the United States of America, which is home to many people of various national origins. As a result, most Americans do not equate their nationality with ethnicity, but with citizenship and allegiance (Barbour, 2013). Sola-scriptura - is Latin ablative which means “by scripture alone” it is the Christian doctrine that views the bible as the supreme authority of all matters of doctrine and practice (Mathison, 2001). Hebrew Israelites – a group of African/ Black Americans who have traced their roots back to the descendants of the ancient Israelites (Jackson, 2013). Ethnography- the study of social interactions, behaviors, and perceptions that occur within groups, teams, communities, organizations (Creswell, 2009). Paper Genocide – the act of suppressing and manipulating scientific, historical, and religious documentation based on one’s culture, ancestry to purposefully deceive or change the perceptions about a race of people. Significance of the Study The significance of this study is to explore how mistrust plays a role in their cultural experiences with racism and oppression and shape perceptions that Black Americans may have about psychology. Moreover, equally important is how the psychology field can become more

7 culturally competent by integrating and exploring those experiences to make them more comfortable and more willing to seek out or continue treatment. Due to the extensive trauma, this population has and continues to face in the United States, this study seeks to explain how best to service, and find a way to begin healing they deserve for a sustainable life. We must understand the trauma Black Americans have faced in the U.S. this people experienced harsh treatment during their captivity, upon their release they were not provided any form of therapeutic treatment. They experienced harsh treatment after their captivity, yet and still were not provided any form of therapeutic treatment. Given all the hardships these people face, one must have recognized and understand why the skepticism in seeking out treatment. The social disconnect between the psychologist and this population decreases retention of therapy. Psychologists interested in cultural variables often fail to identify the characteristics of culture that is thought to influence one’s behavior (Awosan, 2011). Whaley’s, (2001) research indicated that paranoid schizophrenia is a most frequent diagnosis given to Africans, based on the terms used by clinician’s insensitivity to different cultural norms for paranoid ideations in the black population (Blando, 2006). Never the less, this explanation embodies an untested assumption based on the pragmatic research on such topic has given only descriptive accounts to the phenomenon (Shaw, 2007). The act of behavior is not a fluke; it is the bases of cause and effect, which is impacted by the thoughts that enters in to the psyche of an individual (Chowdhury, 2006). Society has long viewed science as an unflawed instrument of unprejudiced truth (Mirowski, 2011). Through this study one will see the flawed system in which we use as an instrument on which we base our educational and societal facts upon (Stringer, 2005). Lastly, blacks are often shunned when they seek truth of their heritage and told that race does not matter (Thomas, 1978). But, if this is the

8 case why is there a constant act to dilute and cover up historical facts that could bring comfort in knowing their identity; which will result in inner healing (Landrine, 1996). Lastly, it adds to the body of knowledge, future opportunities for both qualitative and quantitative research and validates the historical trend to undermine the black mind. “This researcher has coined the term paper genocide.” Paper Genocide – the act of suppressing and manipulating scientific, historical, and religious documentation based on one’s culture, ancestry to purposefully deceive or change the perceptions about a race of people. Initial Review of Literature The Psychological needs not being served for Black Americans There is considerable evidence that racism and internalized oppression are primary causes contributing to this mistrust (Sue, 2007). Discriminatory practices in psychology negatively impact the Black American community’s experience and understanding of the mental health care system (Suite, 2007). The distrust in psychotherapy partly comes from the government experimenting and researching on African American years ago (Veracity, 2006). For example, The U.S. Public Health Service in Tuskegee, Ala. diagnoses 400 poor, black sharecroppers with syphilis but never tells them of their illness nor treats them; instead researchers use the men as human guinea pigs to follow the symptoms and progression of the disease (Veracity, 2006, pg. 1833). Furthermore, the theoretical base of psychotherapy itself is incongruent with the African American community because it is based in the European culture (Haviser, 2006). The need for research exists, because of cultural differences between blacks and whites. For example, the history of American psychology literature on blacks is negatively biased (Awosan, 2011). “Within the western worldview, humanity is viewed as an object and promotes objective (external, outside of oneself) methods of knowing the self” (Akbar, 1994, pg. 4). Whereas in the African American

9 community, humanity is thought to be a place of healing and the self is known through our spiritual connection with God. Akbar (1994), notes that this difference occurs because Western psychological studies are solely based on human behavior while Black Psychology analyses transformation, transcendence, and spiritual enlightenment. Discriminatory practices within the Christian church According to Blacks Demographics.com 83% of African Americans are Christians, 1% of them are Muslim. Many scholars estimate that 15% of Africans imported as slaves were Muslim (Segal, 2002). Many of the remaining practiced indigenous forms of worship (Segal, 2002). All the slaves were forced to drop their spiritual beliefs and was converted to a European version of Christianity (Watlington, 2006). This version of Christianity removed the black faces of the bible and preached that Ham was the father of the dark race only, and that Ham was cursed; therefore, the black race was cursed (Tenney, 2011). Per Tenney, (2011) Ham is the progenitor of the dark races, but not the Negros. These versions of history, steeped in racial prejudice, were the allegations to provide a biblical justification for black slavery and the subjugation of the black people (Inwood, 2008). It is no secret that many European artists of whom were commissioned to paint their works of art in the churches by the papacy; and the bible commentators that painted and described all biblical characters, including God as white (J. Haviser, 2006). The acts of exclusions are only one side of the problem, there were myths and fables told to remove the presence of blacks from the bible as well as history (Shaw, 2007). These images of European Christianity are a constant reminder of an inferior race, even in their house of worship (Shaw, 2007).

10 Are Current psychotherapy practices not effective with the Black Americans due to not being biblically based? Spirituality warrants a distinctive consideration when treating this population, which is often seen as religiosity (Plante, 2007). Religiosity and spirituality are, however, considered dissimilar, but confluent domains in the lives in the Black Americans (Watlington, 2006). Research suggests that Black American people make complex distinctions between the spiritual realm that exist within the ramification of the supernatural (e.g. Elohim), rejected by the scientific community and those that exist as part of the secular realm of life (e.g. ancestors) (Vandenberghe, 2012). According to Clark (1999) Transformative Theory, is the process of "perspective transformation", with three dimensions: psychological (changes in understanding of the self), convictional (revision of belief systems), and behavioral (changes in lifestyle) (p.76). To collectively address the effective therapeutic approach to treating the African American Christian community Transformative Theory encompasses healing of the total self (Akbar, 1998). A transformative approach helps engage clients to develop their sense of values and morality and inspires them to be involved collectively and efficiently with health and social affairs (Reed, 2014). Yet, it also equips clients with practical skills that allow them to be actively evolving from a personal or collective experience and involvement with a clinician. Discriminatory practice used in psychology (Assessments, Therapy/ Theory, and Interventions) Per Webster (2011) discrimination is the treatment or consideration of, or making a distinction in favor of or against, a person or thing based on the group, class, or category to which that person or thing belongs rather than on individual merit. Uncovering methods behind discriminatory actions is difficult to measure because attitudes about race, gender, and other

11 characteristics often serve as a basis for differential treatment are not easily observed or measured (Haviser, 2006). Thomas (1978) saw the need of ensuring justice and positive social change about racism. The author stated that the behavioral scientists who attempt to further the interests of Black Americans cannot ignore the fact that racism is embedded within our society (Thomas, 1978). The article recommends that in order, for the field of psychology to be responsive to the needs of blacks and other oppressed groups, they must eradicate racism and injustice within their own disciplines (Thompson, Amatea, & Thompson, 2014). Holliday (2009) explains how segregation posed as a form of internal and externalized slavery, which leads to internalized shame. Altogether, the legacy of the philosophy of slavery, the influential patterns approved by the Black Codes (which legally endorsed segregation and subordinate Black social and political status) (Holliday, 2009). Holliday (2009) goes on to state that the attitudes underpinning the behavioral patterns of Jim-Crowism promoted scientific racism wherein the behavior of White Americans was interpreted as appropriate and normative, whereas Black American behavior was interpreted as inferior and non-normative (Holliday, 2009). To effectively serve the Black American community, there needs to be a synthesis of principles from clinical and social psychology interpreted from the black perspective (P. Richards, 2005). It is necessary to place an emphasis on group processes among the black populations. It is also necessary to understand counseling processes and problems related to the black individual, child family, and marriage (Awosan, 2011). Awosan (2011) divulges the importance of understanding the dynamics of black/white Counseling processes and problems as related to the black individual, child family, and marriage. As well as, viewing the dynamics of black white relations; and issues and understanding the legal aspects of counseling black children, individual,

12 family, and marriage. Thus, it is proposed that rendering culturally congruent therapeutic interventions and case conceptualization increases the rate of attendance of African American clientele which this study will aide in doing (Suite, 2007). Culturally congruent therapeutic interventions and case conceptualization needs are unmet due to the underutilization of mental health services by the Black American community. Awosan (2011) stated that utilization of therapy is limited because of the multitude of barriers to attend treatment. Concern over cultural miss attunement and lack of family support in the treatment process were the two main barriers to therapy attendance (Suite, 2007). Gilbert (2009) exposes fundamental differences in the psychologies of people of African and European descent which are stated below. These differences, which are manifested in the oppressive behavior of Europeans, “must be revealed before black Americans can recreate an authentic Black psychology” (Awosan, 2011, p. 155). The following quotation illustrates what sparked the need for an ethnic-centered psychology. Proposed Sample (Participants) The Black church has been a cornerstone in the advancement of Black Americans, so it is obvious to use them as a place of recruitment (Reed, 2014). The study will involve black Americans from age 18 to 75 whom identify themselves as bible believing based on sola-scriptura (Mathison, 2001). Sola-scriptura is Latin ablative which means (by scripture alone) it is the Christian doctrine that views the bible as the supreme authority in all matters of doctrine and practice (Mathison, 2001). Their religious or spiritual beliefs could also be identified as devout Christians or Hebrew Israelites. This identification that is due to this group of people will have the greatest resistance to traditional psychotherapy treatment (Awosan, 2011). The study will use a convenience sample of 60 to 100 volunteers. The researcher will gain access to the participants

13 using online survey service flyers (Appendix E). Phones calls, emails, and face-to-face interactions were the primary means of inviting the participants to agree to partake in the study. The researcher will keep accurate record of all persons involved in the participants process through Microsoft word and excel software. Study participants are to be recruited through online survey service. Each person whom agrees to participate in the study will be asked to read and sign an informed consent (Appendix A) form prior to participation and will be assured their complete privacy. Mixed method research has indicated that Black Americans are reluctant to participate in research (Johnson et al., 2008). In addition, the issues of race, religion, and oppressive factors in the United States are sensitive topics that may increase reluctance for this group of people (Suite, 2007). The quantitative component will use a purposeful sampling strategy which is to be the best fit for this study, per Glaser and Strauss (2006); this strategy allows the researcher to choose any group that will aid in generating to the full extent, “as many properties of the categories as possible, and that will help relate categories to each other and to their properties.” The ethnographic qualitative component will utilize brief open-ended exclusion criteria survey (Creswell, 2009). All completed surveys submitted by Black American adults at least 18 years of age are to be included in the sample. Limitations The limitations of the study included the restriction of participants from other religious denomination; therefore, no comparative information is available. Another limitation is that the study was limited to a specific region and participation will be based solely on the African American attending specific churches. The qualitative research method selected for this study was also a limitation as the sample size was relatively small and focused on a collection of individual responses and perspectives.

14 Description of Data Analysis Procedures The data analysis within this study is not aimed at explaining why people act a certain way, but instead seeks to explore the way people make meaning in their social worlds (Stringer, 2005). This study will use several data sources to include surveys (Appendix), and demographic questionnaires (Appendix). This mixed method study will use a nonexperimental survey design, with data collected through a web-based screening script. An on-line survey is chosen for three reasons: 1. Convenience: (a)most of today’s generation are multitaskers and lead busy lifestyles; this allows for easier access to those that might not want to go out to a location. (b) Using the internet allows the researcher a larger pool of participants and rapidly collects data within a short period (Creswell, 2009). 2. An online survey is cost efficient (Fortunato, 2016). 3. The participants are likely to feel more comfortable answering questions about sensitive issues or personal experiences anonymously, rather than in person or by phone (Creswell, 2009). The intent of this study is to identify a model has the greatest impact on Black Americans therapeutic consistency based on: (1) age, (2) demographics, (3) Black racial identity, (4) racial discrimination, (5) self-efficacy, and (6) religious/spiritual support, independent variables that represent the factors that are identified in the literature as having a relevance to understanding the unique stressors and supports.

15 This mixed method study will consist of three main phases of research design. In this mixed method study, will consist of three main phases of research design (Creswell, 2009). Mix-method approach is to be applied in three consecutive phases, with the results of one phase influencing the process and application of subsequent phases. In the first phase, the participant’s demographics (appendix C); The second phase quantitative, a Likert formal survey (appendix E) will be applied to identify the participants’ perceptions about the importance of their spirituality and how they perceive mental health programs should reflect their personal values. In the phase third is the ethnographic qualitative, exclusion criteria survey (appendix D) is where in-depth the needs of clients are defined using the open- and close-ended questions to wen out a selection of five to seven participants to move on to phase three. Ethical Considerations One ethical consideration is a greater understanding mental health needs in the Black church, because mental health is considered taboo in the Black church community (Hill, 2006). It is necessary for the researcher to remain objective and conscious of bias to not compromise the integrity of the study in any way. According to Greenwood and Levin (2007), a competent action researcher can shift between context-free and contextual components involving interventions, situations without trying to influence the outcome of the study (p.125). Everything is to be made to minimize any ethical concerns that might arise during the study. The informed consent is to be extensively reviewed, in addition to ensuring that participants fully understand the nature of the study and purpose of the study (Creswell, 2009). This action aids in the reduction of minimal to no risk. This study could be considered sensitive due to the questions of the study that maybe viewed as a personal nature. All efforts are to be made to present

16 the questions in a manner that do not provoke discomfort of distress. Participants are to be informed that they can withdraw from the study at any time without penalty. If a participant becomes distressed from the research process, the protocol is to provide the participants with both a referral to identified ministerial support staff affiliated with the participating churches in the study and a psychotherapist identified in the southern California geographic area. Conclusion This literature review will explore the following areas of concern: The Psychological Needs not being served for Black American Christians, Discriminatory practices within the Christian church, Discriminatory practice used in psychology (Assessments, Therapy/ Theory, and Interventions), Current psychotherapy practices that are not effective with the Black Americans due to not being biblically based, Culturally congruent treatment modalities for the Black, the Most Effective Biblically Based Theories Utilized to Provide Psychotherapy to Black Americans, whether black Americans have lost their identity as a result of assimilation with the majority culture, European Americans and How the culturally congruent modalities line up with biblical doctrine. Different disciplines such as psychology and religion will be explored to understand the components of humankind’s nature as these components relate to the wellness of clients and the role of a transformative and spiritual counselor treating the Black American community.

17 Chapter 2: History, Race, and Literature Review “If you tell a lie big enough and keep repeating it, people will eventually come to believe it… This is the greatest enemy of the state,” (Weber, 2011, p. 65). The United States educational system provides students of all backgrounds with a limited amount of culturally congruent historical accounts (Martin, 2001). Black Americans exposure to a one-sided view-point of their (Elaborate) place in history only adds to a disconnection of lost identity, perpetuated stereotypes, and whitewashing of their rightful place in history (Akbar, 1994). It is often said that history is written from the perspective view of the winners. Historical revisionism is a practice in historiography in which a historian reinterprets traditional picture of causes and effects, decisions, and evidence (Merriam-Webster, 2015). An example of historical revisionism as it pertains to Blacks in history is the whitewashing of Egyptian history (Jackson, 2013). The historical view of the people of Egypt is always portrayed as Caucasian, even though the hieroglyphs and historians of antiquity revel the indigenous people as being black (Jackson, 2013). Not only were the images changed, but the names of the regions and territories is a constant reminder of these disregarded fallacies (Martin, 2001). Take the recent scandal regarding the textbook publisher McGraw Hill; a student publicly disclosed this excerpt taken from his world geography book “The Atlantic Slave Trade between the 1500s and the 1800s brought millions of workers from Africa to the southern united states to work on agricultural plantations,” (Schaub, 2015). The educational system continues to indoctrinate Black Americans through the whitewashing of history, the unimportance of their cultural identity. According to Hosea 4:6 “My people are destroyed for lack of knowledge: because thou hast rejected knowledge, I will also reject thee, that thou shalt be no priest to me: seeing thou hast forgotten the law of thy God, I will also forget thy children,” (Cambridge, 2015, p. 1450). The passage of

18 Hosea shows the importance of knowledge, and the impact of one’s livelihood if one does not obtain it. The importance of understanding one’s heritage is to know thy self, thus the need to revisit the history of Black Americans. To understand the best method of treatment, we must revisit the historical account as to why Black Americans were placed in bondage, and the psychological, spiritual, and physical impact of them being in bondage. The origin of the Negro race can be traced all the way back to the beginning of civilization (Akbar, 1994). Deuteronomy 28 shows the consequence of the Hebrew if they as a nation would dishonor the vows that they as a country swore to commit to in the wilderness at the base of Mount Sinai. Deuteronomy 28 states “And the LORD shall bring thee into Egypt again with ships, by the way whereof I spake unto thee, thou shalt see it no more again: and there ye shall be sold unto your enemies for bondmen and bondwomen, and no man shall buy you,” (Cambridge, 2015). If we are to see that only one people fit this disruption, which we know as the African diaspora. The attempt to integrate psychology and theology has been an ongoing attempt by both psychologist and theologians alike (Blando, 2006). The misconception by both is that they can be integrated if one is to analyze theology and psychological theories honestly, one will see they can’t commingle (P. Richards, 2005). This research will illustrate how fear and misunderstandings regarding the mental discipline can be alleviated or give a sense of awareness of the theories, and new culturally competent modalities in Christian psychotherapy for the Black American population can be utilized for effective treatment. There was a review of the philosophical, psychological, spiritual, creative, and sociological aspects of Black-Americans in a way that is accessible to all people. It is necessary to reconnect the historical and religious findings within the personal context, which has directed the researcher into this research. There is a connection

19 with the literature from a Christian perspective. The thesis explores a cross-cultural perspective, included genres of spiritual literature, to assist with the spiritual component of the research. History Unlike most non-black Americans, the trace of their history is often unknown, whitewashed, or hidden (Shaw, 2007). Most Americans’ exposure to Black history is through the educational system, which seems to downplay Black American contribution to America and the world (Awosan, 2011). It is often told that America was a nation built upon the values of Christianity, which is where the history of the Negro people begins. According to the Genesis flood account Noah had three sons Shem, Ham whose name meant Black, and Japheth whose name meant fair (Cambridge, 2015). The descendants of Noah’s sons: ❖ Shem: Elam (East Indians), Assyria (Assyria or Kurds), Lud (Lydian), Aram (Aramaic, Armenia, Mesopotamia, Syria), Arphaxad: Terah the father of Abraham: Ishmael and Isaac: Esau (Edomites also known as Pharisaic Jews) and Jacob (twelve tribes of Israel) ❖ Ham: Mizraim (Egypt), Cush (Sudan, Ethiopia), Phut (Lybia), and Canaan (Hivites, Jebusites, Arvadites, Girgashites, Amorites, Arkites, Sinites, Hittites, Sidonians, Perizzites, Zemarites); ❖ Japheth also known as the Aryan or Indo-European nations: Gomer (Riphath: Paphlagonians, and Europeans and Togarmah also known as Armenia), Magog (Scythians, Slavs, Russians, Bulgarians, Bohemians, Poles, Slovaks, Croatians), Madai (Indians, Iranic: Medes, Persians, Afghans, and Kurds), Javan (Elishah, Tarshish, Kittim, and Dodanim which is what we know today

20 as Grecian, Romans, France, Span, Portugal), Tubal (Turkey), Meshech (Russia), Ashkenaz: (or Khazarians), and Tiras (Thracians, Teutons, Germans, Scandinavian, Anglo-Saxons, Jutes) (Cambridge, 2015). According to Newitt & Brockey (2011) who wrote about John Ogilby, “ Master of his majesty‘s rivals in the kingdom of Ireland, published in 1679 as volume on Africa, wherein he speaks of the coast of Guinea as follows: “the Black Jews emigration from Portugal to West Africa, and the American islands on the east coast which was the beginnings of the black diaspora associated with the slave trade (Newitt & Brockey, 2011).” Many Jews also are scattered over this region; some Natives, boasting themselves of Abrahams seed, inhabiting both sides of the river Niger (Bruder, 2008). They fled there either from the desolation of Jerusalem by Vespasian; or from Judea wasted and depopulated by the Romans, Persians, Saracens, and Christians (Newitt & Brockey, 2011). “Some come out of Europe when they were banished out of some parts of Italy in the year 1342. Out of Spain in the year1462. Out of the Low Country’s in1350. Out of France in 1403. Out of England in 1422 (Bruder, 2008).” They all differ inhabit for the surrounding tribes, and are divided into several Tribes, having no dominion, through both wealthy and numerous, “but despised of all nations, and so abominated by the Turks, that they are not admitted to be Muslims, unless first baptized: and then no otherwise made use of, than to receive their customs, and gather in their taxes (Newitt & Brockey, 2011).” According to Zephaniah 3:10” From beyond the rivers of Ethiopia my suppliants, even the daughter of my dispersed, shall bring mine offering beyond the Rivers of Cush (Cambridge, 2015).” Also, in Isaiah 18:1-2 it states that “Alas, oh land of whirring wings which lies beyond the rivers of Cush, which sends envoys by the sea, even in papyrus vessels on the surface of the waters. Go, swift messengers, to a nation tall and smooth, to a people feared far and

21 wide, a powerful and oppressive nation whose land the rivers divide (Cambridge, 2015).” The bible speaks of the Hebrew people being supplanted in Africa because of their disobedience, as well as how they would be despised in every place they would live. We see the evidence of this during Antebellum era, Jim Crow era, civil rights era, as well as in modern America. By understanding the magnitude of Black Americans challenging experience in the American society and uncovering the hidden history, we can begin the healing process of the people impacted by it.

Negroland and Guinea, (Moll, 1729)

By uncovering precolonial history, we seek to shade light on the indigenous coppercolored people that resided in the land before Columbus venture to the American shores. There where Hebrews already in America before the time of Columbus (Jackson, 2013). The Moors and natives had been trading for many years. In Columbus’s records, it showed that he purposefully brought Hebrew and Islamic interpreters with him on is journey (Jackson, 2013). The documents also show that some native Americans spoke paleo-Hebrew and continued in the Hebraic customs as their forefathers did (Jackson, 2013). The language connection between the

22 Eastern seaboard indigenous peoples and the west African are similar (Tuchecherer, 2002). When examining the VAL Script (writing system), the similarities of the Cherokee script and the Sub-Saharan African scripts of Liberia, Mende, and Sierra Leone (Tuchecherer, 2002). We have also found that the natives were called negro like those who were captured in Africa, this act removed any identity of the people and forfeited any ties the natives have to the land (Jackson, 2013). The native Negros who were captured were also shipped to the islands to elevate escape because they knew the nation and would often run away when taken (Jackson, 2013). Though history elevates the indigenous Coper People from its history books, there was an estimate of 30,000 to 50,000 indigenous people as slaves shipped to the merchant operating out of Charles Town, Carolina between 1670 and 1715 (Barbour, 2013). This is due to the higher cost of shipping slaves from Africa, and whites in the northern colonies sometimes preferred Native American slaves; especially women and children to blacks (Holliday, 2009). Most Native Americans were used on sugar cane and Tobacco plantations due to their knowledge of planting and growing these products (Shaw, 2007). The Africans knowledge was in cotton growing, which was the reason they were placed on cotton plantations (Shaw, 2007). Due to the countless documentation of the cruelty of slavery, Jim Crowism and the civil rights era this researcher has chosen to omit further history of the Black American. The Purpose of Creating Races Through the striping of culture, heritage, and family values to fit society, allows one to be easily indoctrinated without questioning those societal norms that will otherwise cause alarm, or the breakdown of one’s cultural identity (Suite, La Bril, & Primm, 2007). The effects of cultural restrictions on the black American race aids in devaluing and oppressing this population of people. Per Jones & Campbell (2011) describes the subjective psychological nature of culture as

23 the way cultural groups view the human-made part of their environment. For example, personal culture is characterized by two essential features that are derived from human interaction: •

An individual's view (expectation; interpretation) is influenced by one's experiences as well as the interactions others in the group may have.



an individual may hold symbolic representations of the group's values and skills, which affect behavior at a given moment in time (Jones & Campbell, 2011)

The interpretive framework of the statement above depends not only on the cultural group's experiences directly with those outside of their culture, but their perceived experiences about others in their cultural group have had at various times. Their identity bases and symbolic beliefs play a critical role in what a person feels, sees experiences, and thinks. Through the creations of races; one’s culture, tribe, religion and personal experiences have been stripped away. The very essence of a collective people is gone and is instead replaced by a culture unfamiliar to those people. This integration devalues the cooperative people’s heritage, an example of how combination has impacted Black Americans is a dual cultural ideology. One would ask a Black person if they have a public or work persona and a different one at home, most would tell you that (when I go to work I talk and behave white, but when I go home the black person comes out). This is one of the multiple dualities these people have experienced due to the removal of their cultural ideology. Race Reclassification The term Negro, literally means (black), it was used by the Portuguese and Spanish as a reference to describe the Bantu peoples in what we call today west Africa (Nguyen, 2004). Now, this term is used to describe all people of color around the world. Through this type of classification indigenous peoples are stripped of their cultural heritage and grouped into one

24 category of peoples. The term Paper Genocide is used to describe how the Native American ancestry was suppressed in administrative records reclassified as Black, White, Hispanic/Latino. This reclassification systematically and deliberately destroys the language, culture, and identity of the Native peoples. Around the beginning of 1790, the United States census began to list Native Americans falsely as Negro, Colored, Mustee, Mulatto, or Colored. Carolinas, number counts of Indian slaves are more than likely in the hundreds of thousand when including other areas in North America. It is estimated that Carolina merchants operating out of Charles Town shipped an estimated 30,000 to 50,000 Indian captives between 1670 and 1715. This was a very profitable Indian slave trade with the Caribbean, Spanish Hispaniola, and northern colonies, thus the purpose of race reclassification.

The African American community and psychotherapy There is considerable evidence that racism and internalized oppression are primary causes contributing to this miss trust (Reed, 2014). Discriminatory practices in psychology negatively impact the African American community’s experience and understanding of the mental health care system (Awosan, 2011). The distrust in psychotherapy partly comes from the government experimenting and researching on African American years ago (Veracity, 2006). For example, The U.S. Public Health Service in Tuskegee, Ala. diagnoses 400 poor, black sharecroppers with syphilis but never tells them of their illness nor treats them; instead, researchers use the men as human guinea pigs to follow the symptoms and progression of the disease (Veracity, pg. 1833). Furthermore, the theoretical base of psychotherapy itself is incongruent with the African American community because it is based in the European culture (Holliday, 2009). The need

25 exists, because of cultural differences between blacks and whites. For example, the history of American psychology literature on blacks is negatively biased (Suite, La Bril, & Primm, 2007). Within the western worldview, humanity is viewed as an object and promotes objective (external, outside of oneself) methods of knowing the self (Akbar, 1994, pg. 4). Whereas in the African American community, humanity is thought to be a place of healing and the person is known for our spiritual connection with God (Reed, 2014). Akbar notes that this difference occurs because of Western psychology studies solely human behavior during Black Psychology analyses transformation, transcendence, and spiritual illumination.

What psychological needs that are not being served for Black Americans? To efficiently serve the African American community there needs to be a synthesis of principles from clinical and social psychology interpreted from the black perspective (Z. Nadirshaw, 2004). Emphasizing group processes among the black populations is necessary. Thus, it is postulated that rendering culturally congruent therapeutic interventions and case conceptualization increases the rate of attendance of Black American clientele (Reed, 2014). Culturally congruent therapeutic interventions and case conceptualization needs are unmet due to the underutilization of mental health services by the community. Awosan (2011) stated that utilization of therapy is limited because of the multitude of barriers to attending treatment. Concern over cultural misattunement and lack of family support in the treatment process were the two main barriers to therapy attendance (Robinson, 2008). Gilbert (2009) exposes fundamental differences in the psychologies of people of African and European descent which are stated below. These differences, which are manifested in the oppressive behavior of Europeans, must be revealed before Africans can

26 recreate authentic Black psychology (Suite, La Bril, & Primm, 2007). The following quotation illustrates what sparked the need for ethnic-centered psychology. The strengths perspective empowerment theory, and the person-in-environment framework have supported the profession's move toward ethnic-centered interventions, which at minimum should emphasize the cultural competencies of the practitioners and attention to salient ethnocultural factors, such as beliefs, language, and traditions (H. Neville, 2009). More efforts should be made to disseminate information about existing Afrocentric interventions, with emphasis on documenting those that have been evaluated and those that need additional studies, with the aim of developing guidelines for evidencebased Afrocentric practice (Gilbert, 2009). Per Webster (2011) discrimination is the treatment or consideration of, or making a distinction in favor of or against, a person or thing based on the group, class, or category to which that person or thing belongs rather than on individual merit. Uncovering methods behind discriminatory actions is difficult to measure because attitudes about race, gender, and other characteristics often serve as a basis for differential treatment are not easily observed or measured (H. Neville, 2009). Thomas (1978) saw the need for ensuring justice and positive social change regarding racism. The author stated that the behavioral scientists who attempt to further the interests of Black Americans could not ignore the fact that racism is embedded in our society. The article recommends that for the field of psychology to be responsive to the needs of blacks and other oppressed groups, they must eradicate racism and injustice within their disciplines. Holliday (2009) explains how segregation posed as a form of internal and externalized slavery, which leads to internalized shame.

27 Simultaneously, the legacy of the ethos of slavery is the institutional patterns sanctioned by the Black Codes (which legally endorsed segregation and low Black social and political status). In addition to, the attitudes underpinning the behavioral patterns of Jim-Crowism promoted within the novice discipline of psychology a type of scientific racism wherein the behavior of White Americans was interpreted as appropriate and normative, whereas Black American response was interpreted as inferior and nonnormative (Washington, 2008). The review of this literature explains the racial constraints of psychological modalities as it relates to Black Americans in psychology: 1. Questions mainstream authority that has informed cultural and social thought; 2. Caused Black Americans to have loss of identity and heritage; 3. Challenge personal truth that has been held sacred and unseen. The use of justice and positive social change about racism is a clear explanation which makes it easy to understand. Modern Western Psychology’s background came from a European perspective and therefore only addresses issues from this perspective (Watlington, 2006). “The blind copying and imitation of Western psychology by Indian psychologists was a response to the “feeling of inferiority” that they experienced during the colonial times” (Nandy, 1974, p. 7). Nandy felt distinctions between westernization and modernization have not touched the bulk of western educated modern Indians, who were convinced that their future lies in being exactly like Europe and North America. 1. Nandy saw how westernizing ideals were defiling the essence of his culture; 2. Western doctrine emphasizes the individuality of the person and ignores the element of transpersonal awareness. An “individual” operating under this reasoning is led to believe

28 that there is no meaningful scientific concept such as a group or a collective being. The idea of a joint mind would require an intangible conception of the mental process. 3. Nandy shows the need of Indians to conform to western views to be productive within their culture. By the 1970s, Indian psychologists were primarily using European and American textbooks in their undergraduate and graduate curricula and were importing European and American standardized intelligence and personality tests to assess the various “abilities” of the Indian population. (S. Shields, 2009, p. 116) 1. Shields states that all publications and treatment modalities were culturally biased; 2. To ensure a non-biased publication and modalities, psychology needs to be culturally competent. 3. “From the perspective of the West, the observable activity a person engages in is an accurate picture of his or her essential being. Per Nandy (1774) psychology was limited and for those who are non-European. Nandy felt that psychology did not address and incorporate the essence of the authentic Indian culture. This was also the reason that Association of Black Psychologists was created. Black psychologists felt that the American Psychology Association (APA) failed to address these issues. APA’s lack of responsiveness to the interests and needs of Black American psychologists and the communities they serve (Holliday, 2009) leads to the next segment of literature about culturally congruent treatment modalities. What are the best culturally congruent treatment modalities for the Black Americans? According to Clark (1999) Transformative Theory, is the process of "perspective transformation," with three dimensions: psychological (changes in understanding of the self),

29 convictional (revision of belief systems), and behavioral (changes in lifestyle). To collectively address the practical therapeutic approach to treating the Black American community we must review how to heal the whole person (Reed, 2014). A transformative approach helps engage clients in developing their sense of values and morality and inspires them to be involved collectively and efficiently with health and social affairs. It also equips clients with practical skills that allow them to actively evolve from a personal or collective experience to involvement with a clinician. In society, culture has been defined in various ways. Most definitions refer to a set of contexts, e.g., structures and institutions, values, traditions, and methods of engaging with the social and nonsocial world (Shweder & LeVine, 1984). As well, the focused on the process of healing and nurturing the soul of humanity in the inner healing process (Sandford & Sandford, 1982; Johnson, 2003). One should realize that healing will occur within the lives of people through the process that directly relates to the opening of the spiritual part of Black Americans. What are the best culturally congruent treatment modalities for the Black Americans? According to Clark (1999) Transformative Theory, is the process of "perspective transformation", with three dimensions: psychological (changes in understanding of the self), convictional (revision of belief systems), and behavioral (changes in lifestyle). To collectively address the effective therapeutic approach to treating the Black American community we must review how to heal the whole person (Reed, 2014). A transformative approach helps engage clients to develop their sense of values and morality and inspires them to be involved collectively and efficiently with health and social affairs. Yet, it also equips clients with practical skills that allows them to actively evolve from a personal or collective experience to involvement with a clinician.

30 In society, culture has been defined in various ways. Most definitions refer to a set of contexts, e.g., structures and institutions, values, traditions, and ways of engaging with the social and nonsocial world (Shweder & LeVine, 1984). As well, the focused on the process of healing and nurturing the soul of humanity in the inner healing process (Sandford & Sandford, 1982; Johnson, 2003). One should realize that healing will occur within the lives of people through the process that directly relate to the opening of the spiritual part of Black Americans. African American Psychology and the Church Rubin & Wallen (1997) addresses the gap by investigating the degree to which Black American congregations relate to social service and social action in their communities. The data showed that Black American churches are considerably more likely than Caucasian churches to engage in social work and social service activities independent of a variety of organizational, structural, and demographic issues suspected or known to persuade activism. These findings support that the organizational structure of religious institutions may help to influence churchgoer’s that psychotherapy is a useful solution to help improve one’s mental health. Rubin & Wallen (1997) also states that significant regarding using the Black American church to aid in spreading awareness of positive views of mental health. The study shows the influence of the Black American church within its community. The article supports the theme of culturally congruent treatment modalities by incorporating the client’s faith within treatment to ensure non-skeptical views of psychology. It also provides mediation between the clinician and the population being served. An example of the usefulness and impact the Black church has in shaping ideology is the use of the black church to spread eugenics birth control. An example of the usefulness and impact the Black church has in shaping ideology is the use of the black church to spread eugenics birth control. In 1939 Margaret Sanger constituted

31 The Negro Project, was developed by white birth control informers with the aid of Black Americans as W.E.B. DuBois, Rev. Adam Clayton Powell, and May McLeod Bethune in promoting the project after its inception (Sanger, 1926). Black Eugenicist understood the Black Church was the best way to influence Black ideology. Sanger believed in selective breeding and Black population control, through birth control techniques including voluntary and forced striation of poor Black women (Joyce, 2010). Sanger’s use of Black Eugenicist to help further her cause is still impacting the Black Community today, much of planned parenthood facilities are in Black and Latino communities. W.E.B. DuBois would later team up with John D. Rockefeller to spearhead Tuskegee experiment (Joyce, 2010). Akbar (1994), a Black American clinical psychologist, states the importance of approaching a congruent cultural modality from an African-centered perspective. In his comparative analysis, Akbar (1994) bases his findings on the distortion of the study of psychology in Western psychology to that of studying human behavior instead of transformation, transcendence, and spiritual illumination as advocated in black psychology. Akbar (1994) concludes that: 1.

Within the western worldview, humanity is viewed as an object and promotes objective (external, outside of oneself) methods of knowing the self.

2.

The measure of reality within the western paradigm is “quantification.” All things and matter must be assigned a number for it to be “real.” (p. 4)

3.

“According to Western thought, there is no superior power or purpose in man. With the hasty dismissal of any superior plan, man’s presence becomes meaningless, an existence with no divine purpose. There can be no expectation of human life if it has no direction or higher meaning.” (p. 4)

32 4.

“All invisible or intangible phenomena are considered irrelevant within the Western scientific analysis. It views the soul, spirit, revelation, and intuition as superstition or illusions.” (pg. 5)

This study was approached from an African-centered worldview to know “the “self” as understood in African philosophical thought “that encompasses the spiritual core (soul), a physical body, a personal mind, a social self and a tribal (ancestral) self” (Akbar, 1998, p. 19). By addressing the social-psychological concerns of racism, and its effects on the community, the authors can establish the need for change. According to Parham (2002), ‘A Sense of Self’ is one’s ability that enables and empowers their process as they transform their lives and overcome trials. Another value system for guiding the life and behavior of Black Americans is rooted in the principles of Maat, a philosophical, spiritual, and cultural order that reflects principles for living "to support and facilitate the full expression of one's spiritual essence (sense of self)" (Parham, 2002, p. 41). Through this piece of literature one: 1.

Explores and embraces the sacred (spiritual) self;

2.

Re-connects to the divine sacred within;

3.

Reaffirms, reclaims, and acknowledges the cultural person;

4.

Explores and experiences psych-spiritual wellness from a holistic approach.

Psychology’s background came from a European perspective and therefore only addresses issues from this perspective (Holliday, 2009). This research shows that socio-cultural factors can shape psychological constructs such as the factors that determine how people respond to health treatment and use their social support

33 networks as well as how illness-related thoughts are formed and when behavior is likely to change. It is therefore essential that existing models of treatment modalities are tested crossculturally and modified accordingly. Increasing the understanding of the role of culture in health and wellness a Therapist should be aware of culturally and spiritually sensitive and effective ways of prevention. Despite the growing amount of research on culture and health and the preliminary attempts to collate the vast amount of knowledge accumulated in the previously disconnected subfields of cultural and spiritual psychology, more research is indeed required to assist researchers, practitioners, and untrained professionals acquire a better understanding of how the psychological experiences of illness and health are shaped by individuals’ socio-cultural environment. Culturally congruent treatment modalities for the Black Americans. Grier and Cobbs (1968) first exposed the notion of “healthy cultural paranoia” in their book Black Rage. The perception that Black Americans have developed paranoid-like actions is due to their historical and modern-day experiences with racism and oppression (Whaley, 2001). In society, culture has been defined in various ways. Most definitions refer to a set of contexts, e.g., structures and institutions, values, traditions, and methods of engaging with the social and nonsocial world (Shweder & LeVine, 1984), as well as the, focused on the process of healing and nurturing the soul of humanity in the inner healing process (Sandford & Sandford, 1982; Johnson, 2003). One should realize that healing will occur within the lives of people through the process that directly relates to the opening of the spiritual part of Black Americans.

34 What are the Most Effective Biblically Based Theories Utilized to Provide Psychotherapy to Black Americans? If one views the biblical Exodus with the emancipation of Black Americans side by side, each enriches the other with its perspective of a shared national destiny that moves from slavery to freedom. The Exodus story has always been a common factor and according to Blando, (2006) when we focus on religion and spirituality within psychotherapy there is a value in the incorporation which allows the therapists to connect with their client, to shift outside themselves, and influence a transferable benefit. Have black Americans lost their identity because of assimilation with the majority culture, European Americans? Given the distorted history told them by their masters, Black Americans are said to be a “cultureless race (Scott, 2003).” Black people have always longed to understand and seek out their ethnic identities. Landrine, (1996) found that there has been no maintenance of a “distinctive value system, orientation, or behavioral style that is divergent or incompatible to mainstream society (42).” Some scholars contest the thought that black Americans have been acculturated but possess distinctive cultural characteristics like West African traditional cultures (Suite, La Bril, & Primm, 2007). Considering that Black Americans have been deprogrammed from the time their feet touched the eastern shores of the Americas they were stripped of all that they held dear to them (Washington, 2008). Though in public they seemed to embrace the European cultures and beliefs, in secret they continued to practice cultural rituals and told stories of their ancestors (Reed, 2014). Blacks often brag of their versatile way of being able to turn on and off their blackness to survive in the “white man’s world;” like a chameleon changing their color depending on the environment, it is in (Akbar, 1998).

35 How do the culturally congruent modalities line up with biblical doctrine? To ensure culturally congruent modalities for this population, it must line up with biblical doctrine; if the patterns deviate in any way, it strips away the true spiritual essence of the biblical canon (Blando, 2006). This is the exact essence of the study; if no theory is found to educate the black spiritual experience, then one must be created to satisfy the spiritual, and psychological aspects of this population. The strengths perspective empowerment theory and the person-in-environment framework have supported the profession's move toward ethnic-centered interventions, which at the minimum should emphasize the cultural competencies of the practitioners and attention to salient ethnocultural factors, such as beliefs, language, spirituality, and traditions (Robinson, 2008). More efforts should be made to disseminate information about existing Afrocentric interventions, with emphasis on documenting those that have been evaluated and those that need additional studies, with the aim of developing guidelines for evidence-based Afrocentric practice (Gilbert, 2009) Summary This research shows that socio-cultural factors can shape psychological constructs such as the factors that determine how people respond to health treatment and use their social support networks as well as how illness-related thoughts are formed and when behavior is likely to change. It is therefore essential that existing models of treatment modalities are tested crossculturally and modified accordingly. Increasing the understanding of the role of culture in health and wellness a Therapist should be aware of culturally and spiritually sensitive and effective ways of prevention. Despite the growing amount of research on culture and health and the preliminary attempts to collate the vast amount of knowledge accumulated in the previously

36 disconnected subfields of cultural and spiritual psychology, more research is indeed required to assist researchers, practitioners, and untrained professionals acquire a better understanding of how individuals’ socio-cultural environment shapes the psychological experiences of illness and health.

37 CHAPTER THREE: METHODOLOGY The content of this chapter is a description of the methods used in this study, such as Research Design, Methods of Data Collections, Procedures and Data analysis. This chapter is formulated to explore the relationship between these variables: Spiritual Beliefs, and the fear of receiving external psychological assistance, as well as exploring the benefits and non-benefits of culturally congruent treatment modalities. Lastly, the chapter will conclude a detailed overview of the typical findings. Research Questions and Hypotheses Constructed on the direction of this practical and theoretical literature previously reviewed and the presented conceptual framework of this study, following research questions and hypotheses have been established to guide data analysis, data collection, and study design. Research Questions (RQ) [Aims 1 and 2]: since there is a deficiency in psychology literate regarding Black Americans retention and their reluctance in receiving psychological care, a qualitative inquiry is necessary to address the following RQ’s: RQ1) What psychological needs that are not being served for Black Americans; RQ2) What are the discriminatory practices used in psychology (Assessments, Therapy/ Theory, and Interventions); RQ 3) Are Current psychotherapy practices not practical with the Black Americans due to not being biblically based; RQ 4) What are the best culturally congruent treatment modalities for the Black Americans; RQ 5) What are the most effective biblically based theories utilized to provide psychotherapy to Black Americans? Besides, the conceptualization of Black Americans retention and their reluctance in receiving psychological care at the individual level is poorly understood. The necessity of conceptualizing participant performance reliably, accurately, and in a manner, that facilitates

38 ease of use cannot be overstated in evaluating active efforts within the psychology community. A qualitative inquiry is necessary to address the following research questions: RQ6) What participant characteristics are undesirable and desirable in achieving increased retention and sought out services psychological care? These research questions will guide data collection that can provide the rich descriptions of the participant’s conceptualization of psychological services based on the participant's needs. Hypotheses (H): H1) The Participant’s level of decision making will be positively associated with their spiritual needs; H2) Participant’s spiritual needs will negatively impact their need to seek psychological services. Research Design Mix-method approach was applied in three consecutive phases, with the results of one step influencing the process and application of subsequent stages. In the first phase, was the participant's demographics (Appendix C); the second phase was a qualitative, exclusion criteria survey (Appendix D) where in-depth the needs of clients are defined using the open- and closeended questions to wen out a selection of five to seven participants. These Black Americans were interviewed about their opinions of how their mental health is influenced by their spirituality from the inclusion criteria survey. The inclusion criteria survey used a purposeful sampling strategy which is the best fit for this study, per Glaser and Strauss (2006); this strategy allows the researcher to choose any group that will aid in generating to the full extent, “as many properties of the categories as possible, and that will help relate categories to each other and their properties”

39 Measures A Likert formal survey (Appendix E) was applied to identify the participants' perceptions about the importance of their spirituality and how they perceive mental health programs should reflect their values. The background and demographic information were obtained through the online questionnaire (Appendix C). The demographic facts research consists of age, gender, biracialism, relationship status, the highest level of education, and income status. Individual Questions. The personal questions were obtained through the online questionnaire (Appendix C). The demographic questions consist of religious denomination as well. To permit for more natural distribution and to enhance the potential reach of the study, an online survey is to be created using the internet survey website Qualtrics Survey. The research that was designed through Qualtrics Survey included all measures of interest in the electronic format needed for data collection. The online survey consisted of three components of questions based on demographics, individual open-ended questions, and a spirituality survey based on the core demotions of the participant's spirituality this should be completed between 13 to 15 minutes to complete. Background and Demographic Information. The knowledge and demographic information was obtained through the online questionnaire (Appendix C). The demographic facts research consists of age, gender, biracialism, relationship status, the highest level of education, and income status. Individual Questions. The individual questions were obtained through the online questionnaire (Appendix E). The demographic questions consist of religious denomination,

40 Site Selection As stated in chapter one, the participants were chosen randomly by the researcher by utilizing Qualtrics Survey online platform, invitations describing the research and participation requirements. Participant Access. The researcher gained access to the participants through the use of online survey service flyers (Appendix F) through Facebook. Phones calls, emails, and face-to-face interactions were also primary means of inviting the participants to agree to partake in the study. The researcher kept an accurate record of all persons involved in the participant's process through Microsoft word and excel software. Study participants were recruited through online survey service. Selection of Participants The study involved black Americans from age 18 to 75 who identify themselves as Christians who base their lifestyles (by scripture alone) which is the Christian doctrine that views the Bible as the supreme authority in all matters of theory and practice (Mathison, 2001). Anticipated Sample Size: the use of a convenience sample of 60 to 100 Black American participants recruited through the online survey in the Los Angeles County. Interviewed about their opinions of how their spirituality influences their mental health. After the online screening survey, 5 to 7 participants will be chosen to participate in the final study. Consent of Participation As stated in chapter one, each participant who agrees to participate in the study will be asked to read and sign an informed consent form prior participation and will be assured their complete privacy (Appendix A), informed consent (Appendix B), and confidentiality (Appendix B).

41 Sampling and Sampling Procedures A purposeful sampling strategy was the best fit for this study, per Glaser and Strauss (2006); this strategy allows the researcher to choose any group that will aid in generating to the full extent, “as many properties of the categories as possible, and that will help relate categories to each other and their properties” (p.49). All completed surveys submitted by Black American adults at least 18 years of age were included in the sample. This specific type of participant selection and technique allows the researcher to explore underlying participant experiences, situations, and unapparent essential aspects in addition to placing prominence on the feelings and beliefs of the participants (Creswell, 2009). Furthermore, this manner of recruitment will aid the researcher in ensuring that the study will end with a theoretical sample based on the codes and categories that will surface, and allow systematic variation early on (Bitsch, 2005). Lastly, during the final stages of data collection process is Theoretical Sampling. Theoretical Sampling is precisely focused on testing for further variations, filling in additional detail, and to expound upon the final questions nearing the completion of the research study (Bitsch, 2005). Sample Size The use of non-random sampling was used for the ability that it does not require a sampling frame, and for convenience and speed (Creswell, 2009). According to Charriere, (2010) when using a website as a vehicle for a survey, it is best to use a self-selected sample for the best outcome. The use of concurrently gathering both (quantitative and qualitative) forms of data at the same time, allows the researcher to compare both types of data to search for congruent findings (Onwuegbuzie, 2007). Anticipated Sample Size: the use of a convenience sample of 60 to 100 Black American participants in the Los Angeles County.

42 Methods of Data Collections The survey data was collected anonymously, due to the cost-effective and usefulness of online survey data collection to produce and distribute. The use of this form of data collection is widely accessible to participants who have access to a computer, as online surveys are selfadministered (Creswell, 2009). Most prominently, this form of data collection allows the participants to feel more comfortable in answering questions that are of sensitive nature anonymously, which allows for more openness of feels when responding to online surveys than interviews conducted in person or by telephone (Creswell, 2009). Debriefing and Exit Procedures. Upon the participant's completion of the survey, a brief statement of debriefing was being displayed (Appendix H). This reminded them that the survey was confidential, who to contact if they have any questions, and a contact if they should want to request a copy of the summary results. A reminder of services can be provided due to any feelings of discomfort after completion of surveys, with numbers to counseling or pastoral staff members. Lastly, informed consent provided contact information for the researcher and dissertation chair for any questions or concerns regarding the study and a certificate of completion (Appendix I) following debriefing summery. Limitations Threats to Validity Conducting an online survey poses methodological challenges regarding the internal and external validity of the study. With minimal control over sample selection and data collection conditions, the results of any survey research should always be interpreted with caution (Creswell, 2009; Fink, 2003; Tabachnick & Fidell, 2013).

43

Delimitations Internal Validity Construct Validity. All the above measures described were selected for their confirmed psychometric advantages. The constructed validity of the instrument, the spirituality questionnaire has been demonstrated in published academic literature and was reported in this chapter (Hardt, Schultz, Xander, Becker2, & Dragan, 2011). Examining Internal Consistency. The use of SPSS to explore the internal consistency of all self-report questionnaire instruments to be used in this study. As mentioned previously, prior studies (Hardt, Schultz, Xander, Becker2, & Dragan, 2011) discovered internal consistency in the reliability and the construct validity of the instrument with Cronbach alpha’s ranging between .78 and .97. This study’s estimate of data calculated is compared to those in the published research. Control Over Data Collection Conditions. The use of attributes as independent variables will not allow the researcher to assign to conditions as in quasi-experimental or experimental designs randomly; therefore, increasing the risk of error. Additional outside extraneous variables such as the influence of friends and family completing the online for the participant is also out of the control of the researcher (Creswell, 2009). Incomplete Data. The use of online survey research, participants may cease in completing the survey for various reasons. Hence, missing data is a factor, and this challenges the researcher to address the issues raised by missing data that affect the generalizability of results (Bitsch, 2005). To control this, the following is to be used as a remedy: (1) attempt to over-sample (i.e., the estimated sample size is 40 to 60 participants, 70 to 80 more cases for the power analyses) and,

44 (2) by conducting missing data diagnostics thus to identify non-random data patterns that could skew the results. Statistical Conclusion Validity. Creswell, (2009) reported that one of the significant threats to data analysis is the mistake of stating false results by rejecting the null hypothesis when it did not affect. The researcher will review places that are at risk by committing a Type I error. A Type I error could be induced due to the lack of control over data collection conditions, missing or incomplete data, and weak construct validity. As described above, an effort was made to systematize data collection as much as possible, and planning of missing data analyses before testing the hypotheses. External Validity Sample Size. One must take accountability for a low response rate which could be a threat to external validity, producing too small of a sample size. To reduce such a threat/risk of a type II error (rejecting the null hypothesis that in fact is false), identified various institutions and multiple strategies for recruiting participants. This study will utilize a non-random convenient sampling strategy to maximize the chance of sufficient sample size and variance within the variables. Creswell, (2009) reported the use of this method does not permit the researcher to control the ultimate selection of participants (due to self-selection) or survey taking circumstance. Thus, the inability to estimate sample error and the inability to know how representative the sample is of an accessible population (Tabachnick, 2013). Ethical Procedures Protection of Participants. This present study did not commence until the approval of the Internal Review Board of Argosy University. Before consent in participating in the study, information regarding the study will be provided to all online participants in the Letter of

45 Informed Consent through Qualtrics Survey. Online participants must agree to an online Informed Consent form (Appendix A) before taking the survey. Online participants were provided the opportunity in withdrawing from the study at any time without having to give explanation or reason. Withdrawal from the study would not have any impingement on participant and researcher relationship; nor would it impinge the ties with Argosy University. Although online surveys assume minimal risk to participants, I assured confidentiality of all collected data. No personally identifiable information (like the name of the respondent, address of the house) will be obtained using survey or field observation. Any surveys that might have unintentionally included names or other identifying information will be immediately destroyed. The collected data included no identification information. All survey data will be input into an electronic database online, and one person will only have access to online data. My computer was password-protected. All print-based data were stored in a locked safe to which only I had access; all data, whether in print or on the computer, will be shredded or securely deleted from my computer after five years. Everything is to be made to minimize any ethical concerns that might arise during the study. The informed consent is to be extensively reviewed, in addition to ensuring that participants fully understand the nature of the research and purpose of the study. This action aids in the reduction of minimal to no risk. This study could be considered sensitive due to the questions of the survey that may be viewed as a personal nature. All efforts are to be made to present the questions in a manner that do not provoke discomfort of distress. Participants are to be informed that they can withdraw from the study at any time without penalty. If a participant becomes distressed from the research process, the protocol is to provide the participants with

46 both referrals to identified clerical support staff affiliated with the participating churches in the study and a psychotherapist recognized in the southern California geographic area. Conclusion This study used the expanded Spirituality Questionnaire: Core Dimensions of Spirituality (Hardt, Schultz, Xander, Becker2, & Dragan, 2011); Individual questionnaire (Appendix E); and other demographic variables (age, gender, socioeconomic status, level of education, etc.) as predicting factors that influence black Americans in seeking mental health assistants based on their spiritual needs. Thus, the choice of a non-experimental quantitative online survey design is the most appropriate design for its many previous issues and advantages. The discussion regarding research design and approach, procedures, instrumentation, data collection, data processing and analysis, statistical threats to data analysis results, and protection of participants were discussed.

47 CHAPTER FOUR: RESULTS Restatement of the Purpose The purpose of the study is to expand awareness of an underserved and understudied population in hopes to shed knowledge as to why this population has a fear of seeking help and reduced retention rate in psychological services. The current study provides an analysis of the data collected using mixed methods and presents the results of the analysis. The chapter will lay out the findings based on the five research questions and the hypotheses. The data are shown in tables and figures for clarity. The conclusions of the chapter lead to the discussion, findings, and recommendations for further research. Organization and Presentation Research Questions/Hypothesis The findings of the study are based on the data collected to answer the six qualitative research questions: RQ1) What psychological needs that are not being served for Black Americans; The results of the research shows that the majority of Black Americans do not believe in utilizing psychological services. RQ2) What are the discriminatory practices used in psychology (Assessments, Therapy/ Theory, and Interventions); In the study, 17 (77.27%) indicated that their decision making in social, emotional and psychological matters are affected by their spirituality. RQ 3) Are Current psychotherapy practices not valid with the Black Americans due to not being biblically based; From the qualitative data, Black Americans remain reluctant to seek help from through psychotherapy because of the inherent belief that it is western. RQ 4) What are the best culturally congruent treatment modalities for the Black Americans; According to the research findings whenever Black Americans seek support for emotional or psychological needs, they want to get the answers from the Bible. RQ 5) What are

48 the most effective biblically based theories utilized to provide psychotherapy to Black Americans; The relationship with God for the Black American is a huge part of their belief system. From the study, 20 (90.9%) of the participants strongly agreed with the observation. RQ6) What participant characteristics are undesirable and desirable in achieving increased retention and sought out services psychological care? The relationship with Yahuwah for the Black Americans is a massive part of their belief system. From the study, 20 (90.9%) of the participants strongly agreed with the observation. Thus, it is evident that considering the relationship would improve their trust with psychotherapy. This Section is the Quantitative component were the two hypotheses were tested using the data collected and analyzed from the study. The overall mixed method quantitative section data shows H1) The Participant’s level of decision making will be positively associated with their spiritual needs; these hypotheses were proved to be true based on the participant response. H2) Participant’s spiritual needs will negatively impact their need to seek psychological services; this hypothesis was also proving to be true based on the participants based on the response. Data Collected and Data Analysis Procedures Data Collected. The data collected for the study was in the form of qualitative and quantitative. The first type of data collected is the participant’s demographics (appendix D). The subjects gave their demographics in the form of narratives as follows: the age of the participants, 3 of them were aged between 10 and 20, 4 between 21 and 30, 5 between 31 and 40, 6 between 41 and 50, 2 between 51 and 60, and only one between 61 and 70; the gender, 8 males and 14 females; race, 11 bi-racial, 11 single race; Relationship status, 8 single, 5 divorced, 5 in a relationship, 2 widowed, and 1 married; Highest level of education, some degree in education, 8 had Bachelor’s degree, 4 had Master’s degree, 3 with AA degree, and 1 each with less than a

49 high school education, high school Diploma/GED, and Doctoral degree; religion where all the 22 were Christians; and income where 4 earned up to $15K a year, $3 15-30K a year, 8 earned $3050K a year, 4 earned $50-70K a year, and 3 $70+ a year. Data was also collected in the form of exclusion criteria survey, which is qualitative (appendix B). This is the point where the researcher obtained information from the subjects, which would point to the decision on whether to include or exclude them from the study. The survey had six questions regarding the source of help in times of stress, whether the participant seeks professional help, the way one handles mental health concerns, personal beliefs, the role of the church and pastor, effectiveness of the church as the source of support, and if the person would seek help from a therapist. A Likert formal survey see (Appendix E) was used to identify the participants’ perceptions about the importance of their spirituality and how they perceive mental health programs. The numerical data formed the significant part of the analysis and findings. This is the data collected in the form of numbers from the survey filled by the participants. Data Analysis Procedures. Mix-method approach was applied in three consecutive phases, with the results of one phase influencing the process and application of subsequent stages. To permit for more natural distribution and to enhance the potential reach of the study, an online survey is to be created using the internet survey website Qualtrics Survey. The survey was designed through Qualtrics Survey to include all measures of interest in electronic format need for data collection. The online study consisted of three components of questions based on demographics, individual open-ended questions, and a spirituality survey based on the core demotions of the participant's spirituality this should be completed between 15 to 13 minutes to complete.

50 In the first phase, the participant's demographics see Appendix D; the second phase is qualitative, exclusion criteria survey see Appendix B is where in-depth the needs of clients are defined using the open- and close-ended questions to wen out a selection of five to seven participants. Given the low response and small amount of expected to participants, this researcher opted to use purposeful sampling strategy. A Purposeful Sampling Strategy is to be the best fit for this study, per Glaser and Strauss (2006); this strategy allows the researcher to choose any group that will aid in generating to the full extent, “as many properties of the categories as possible, and that will help relate categories to each other and their properties.” Therefore, all the data collected was used to provide a stronger in-depth view of each participant. These Black Americans were interviewed about their opinions of how their mental health is influenced by their spirituality from the inclusion criteria survey. The background and demographic information were obtained through the online questionnaire see Appendix D” Make sense? The demographic facts research consists of age, gender, biracialism, relationship status, the highest level of education, and income status. The demographic also added questioned their: religious denomination. The inclusion criteria survey used a Formal Likert study see Appendix E to identify the participants' perceptions about the importance of their spirituality and how they perceive mental health programs should reflect their values. Lastly, the individual questions were obtained through the online questionnaire see Appendix B. And was followed by a debriefing page. This reminded them that the survey was confidential, who to contact if they have any questions, and a contact if they should want to request a copy of the summary results. A reminder of services that can be provided due to any feelings of discomfort after completion of surveys, with numbers to counseling or pastoral staff

51 members. Lastly, an informed consent giving contact information of the researcher and dissertation chair for any questions or concerns regarding the study and an attached certificate of completion see Appendix H. Results of the Analysis From the analysis of the data n=22. This means that the total number of participants in the study was 22. The participants met the screening criteria based on the inclusion criteria survey. All the 22 (100%) signed the consent (Appendix A) agreeing to take part in the study voluntarily. The detailed demographic analysis of the data collected from the participants is presented below. The table below shows the age distribution.

Age bracket 10-20 21-30 31-40 41-50 51-60 61-70

Table One n=22 3 4 5 6 2 1

The age distribution tables indicate that the number of individuals in the middle age brackets were the most. This is at the peak of life, and the person is most likely to be facing a myriad of issues associated with work-family demands, responsibilities, relationship struggles, and finances among others (Rowe, 2016). It shows the age at which psychological problems are at the peak. Hence, these are the people most likely to seek help for mental issues, whether from medical or spiritual sources (Perrig-Chiello & Perren, 2005). The individuals at that age are also better at making decisions relating to where and how they seek support for the issues affecting them in life (Rowe, 2016). The age forms the basis for the analysis of the help-seeking tendency of the participants.

52 From the study, the number of males was 8 (36.36%), while there were 14 (63.64%) females. The results confirm the reality that in most churches, females are more than males and the role of gender in religion (Höpflinger, Lavanchy & Dahinden, 2012). Women have more propensity than men to seek refuge in a church or elsewhere when they unable to cope with the life demands. Women are also the most affected by the life realities leading to an increase in psychological and emotional stress. Concerning biracialism, 11 (50%) of the participants agreed to be biracial, while the other 11 (50%) disagreed with the fact that they were biracial. Table 2 is based on Relationship Status.

Marital status Single Married Divorced Serious relationship Widowed Other total

Table Two Percentage 36.36% 4.55% 22.73% 22.73% 9.09% 4.55% 100%

count 8 1 5 5 2 1 22

From the table, it is evident that many of the participants were single, 8 (36.36%). The number of the divorced participants was equal to those who were in a relationship, 5 (22.73%). The widowed participants were only 2 (9.09%). The number of married participants was the least with only one member. The relationship status of an individual plays a role in the level of stress they experience in life. It also indicates their tendency to seek support for mental and emotional problems. Table 3 shows the level of education of the participants.

53

Level of education Less than high school High school Diploma/ GED Some college AA degree Bachelor’s degree Master’s degree Doctoral degree Total

Table Three Percentage 4.55% 4.55% 36.36% 13.64% 18.18% 18.18% 4.55% 100%

Count 1 1 8 3 4 4 1 22

From the data, most of the participants had attained some degree in education. The total of the participants with this level of education was 8 (36.36%). An equal number of participants had bachelor’s degree and master’s degree in 4 subjects (18.18%). The participants with an AA degree were 3 (13.64%). The participants with Less than high school, High school Diploma/GED, and Doctoral degree were 1 (4.55%) in each category. The level education has an impact on decision making regarding seeking help from professional healthcare providers. Concerning the level of income, most of the participants 8 (36.36%) earn $30-50K a year. Those who receive $ up to 15K a year and $50-70K a year were equal in number at 4 (18.18%). Only 3 13.64% earn $15-30K a year and $70+ a year. The financial capability of the individual might play a role in where the person gets services for various needs in life. Table 4 below shows level of income data. Table Four Level of income $ up to 15K a year $15-30K a year $30-50K a year $50-70K a year $70+ a year

n=22 4 3 8 4 3

The table shows that the level of income for many of the participants is in the middle of both extremes. Financial demands are an essential factor in the mental wellbeing of a person.

54 The ability to cater to the needs of the person through legitimate means is associated with a high level of psychological health. On the contrary, not being able to meet the needs can cause problems with psychological health. Understanding the level of income is an essential factor in comprehending the relationship between spirituality and psychological services.

The Psychological Needs Not Being Served for Black Americans The results of the research show that the majority of Black Americans do not believe in utilizing psychological services. As reflected in the literature review, many Black Americans have concerns regarding the effectiveness of treatment; this may be due to a lack of education and cultural reservations. The research shows their apprehension conflict with their values or worldview of therapists can lead to ambivalence about seeking help. The table reflects that 54.55% agree and 36.37% disagree with the fact that Bible believers should seek assistance proving that more should be done to bridge the gap indicating the population's apprehension to receive services. Participants statements from the qualitative exclusion survey regarding their distrust in seeking psychological services are as follows: “because pastors are better equipped to do so. mental institutions never cure people of their ailments; Indifferent about it, I don’t know much about it, and I don’t believe in it.” In addition to the view that mental health treatment was designed by Caucasians for Caucasians, as well as feeling a disconnect regarding social, racial, political, and economic realities they experience. Table 5 below shows the reason why some needs of the African Americans cannot be met through psychotherapy

55 Table Five Do you believe bible believers should use psychological services for mental health needs? Percentage Strongly agree 22.73% Somewhat agree 31.82% Neither agree nor disagree 9.09% Somewhat disagree 4.55% Strongly disagree 31.82% Total 100%

Count 5 7 2 1 7 22

Discriminatory Practices within the Christian Church In the study, 17 (77.27%) indicated that their decision making in social, emotional and psychological matters are affected by their spirituality. Participants statements from the qualitative exclusion survey regarding the impact their spirituality has on their decision making are as follows: “Biblical doctrine influences my views about mental health; It has a great impact on my view of the subject matter; yes, it does have a great impact”; and 11 others just answered yes without explanation. A Discriminatory Practice Used in Psychology (Assessments, Therapy/ Theory, and Interventions) As discussed in chapter two, just like many other aspects of the western culture, the blacks have been discriminated in psychology. This is explained in their continued distrust with the practice even when it is created to help people in dealing with their psychological issues. The attitudes based on the method consider the white’s behavior as the normative while the black’s response is viewed as being inferior and non-normative. Participants statements from the qualitative exclusion survey regarding their distrust in seeking psychological services are as follows: “because pastors are better equipped to do so. mental institutions never cure people of their ailments; Indifferent about it, I don’t know much about it, and I don’t believe in it.” These are the actions that make the blacks to remain out of the system meant to support their mental

56 wellbeing. From the qualitative data, Black Americans continue reluctantly to seek help from through psychotherapy because of the inherent belief that it is western. Research shows that they believe that the experts in the field are less likely to understand their challenges. The participants of the study indicated that the psychological services are not designed in such a manner that they would meet their needs. The services are created with the white client in mind and are not customized to their needs. For those who have sought the services in the past, they indicate that they do not feel like the therapist understands them. Hence, they cannot efficiently provide them the help they are seeking for psychological wellbeing. Those who have never attempted the services indicated that they could not attend them because the therapists do not understand the challenges they face as Black Americans. They have also noted that most of the service providers are whites. Current Psychotherapy Practices Not Effective with the Black Americans due to Not Being Biblically Based The research shows that blacks are most likely to go for spiritual support when they are faced with challenges or when under stress. From the study, most of the subjects indicated that they have religious options to seek when suffered from mental health issues, including praying, fasting and speaking to their pastors among others. This explains why they the psychotherapy practices outside the biblical teachings are not useful in helping them. 17 (77.27%) of the subjects strongly agreed that their relationship with God gives security and peace. Hence, any other system outside what the Bible teaches about the relationship with God does not help to deal with stress and other emotional and psychological needs. According to the research findings whenever Black Americans seek support for emotional or psychological needs, they want to get the answers from the Bible. The participants

57 indicated that they depend on the word of God mostly when they are going through hard times. Hence, they are unlikely to be convinced that help can come out of any other source. Participants statements from the qualitative exclusion survey regarding the impact their spirituality has on their healing process are as follows: “ Prayer, fasting, worship, and meditation on the word of the Most High; Pray, Meditate, Praise and worship, as well as taking to loved ones; Pray, family, and pastoral counseling; I believe what the Bible says about it, we wrestle not against flesh and blood there are things that we cannot comprehend outside of the natural realm; and Prayer. And talking to my pastor” They also indicated that the therapist uses their knowledge to provide counseling which is outside what the Bible teaches. Thus, if the services are not Biblical, there are minimal chances that African Americans will seek them. They will continue to depend on the word of God and the religious leaders for the help. The Best Culturally Congruent Treatment Modalities for the Black Americans Given that the Black Americans are most likely to seek help from the church for emotional and psychological problems. The propensity is founded on a cultural belief that many of the problems they face in life have spiritual explanations. Hence, they tend to seek help from the church and religious leaders. This explains the importance of aligning their interventions to their culture. The Black Americans have diverse beliefs on the use of psychotherapy in the church. Religious beliefs are part of the culture of the Black Americans. Participants statements from the qualitative exclusion survey regarding the best treatment modalities are as follows: “Hypothetically, if I was to decide to seek any psychological services the person would have to be very familiarized with a scripture canon, as well as historical biblical, and African oppression and struggles in the United States; Someone that understands the black struggle and the history of oppression in the United States; When I sought services initially, I specifically looked for a

58 female. She is of a different nationality which was a huge adjustment for me; Someone that understands biblical doctrine and the Black American struggles in America; and a spiritual background and to have the historical knowledge of my people so to better help understand in concerns and how to deal with them from a spiritual perspective.” These people have struggled with the efforts to have their cultural beliefs appreciated. Therefore, the only effective way of having psychotherapy work for them is if it is aligned with their cultural belief system. Potentially, customizing psychotherapy to their needs will help them appreciate and seek the services. Culture provides meaning to the lives of the Americans as the results indicate. It is the cultural beliefs that form the basis for the tendency to seek support from religion and other spiritual sources. The views have been passed on from one generation to the next and might not change anytime soon. From the study, the individuals from all the age-groups have developed the tendency to seek spiritual help for psychological challenges. This behavior has not changed with age. It shows that whatever mental help that targets this population must take into consideration its cultural tendencies. Otherwise, they will still avoid the services. The Most Effective Biblically Based Theories Utilized to Provide Psychotherapy to Black Americans The relationship with God for the Black Americans is a massive part of their belief system. From the study, 20 (90.9%) of the participants strongly agreed with the observation. Thus, it is evident that considering the relationship would improve their trust with psychotherapy. To be more successful, the interventions should be founded on the faith and cultural beliefs of the participants. From the question, does your faith helps you deal with problems you face in life problems, 17 (77.27%) of the participants strongly agreed. Participants

59 statements from the qualitative exclusion survey regarding the impact their spirituality are as follows: “ Prayer, fasting, worship, and meditation on the word of the Most High; Pray, Meditate, Praise and worship, as well as taking to loved ones; Pray, family, and pastoral counseling; I believe what the Bible says about it, we wrestle not against flesh and blood there are things that we cannot comprehend outside of the natural realm; and Prayer. And talking to my pastor” Hence, if it appears to be supportive of their faith, the interventions will work. It will also be helpful if psychotherapy interventions are based on spiritual leadership. Table 6 provides a clear indication of the reality. Table Six Do you believe bible believers should seek assistance? for their psychological needs from a pastor? Percentage Strongly agree 45.45% Somewhat agree 18.19% Neither agree nor disagree 27.78% Somewhat disagree 9.09% Strongly disagree 0% Total 100%

Count 10 4 6 2 0 22

From the data, the spiritual leadership plays a critical role in their emotional and psychological support. As a result, they will most likely go for psychosocial help if they are based on their religious beliefs and religious guidance. The participant characteristics which are undesirable and desirable in achieving increased retention and sought out services psychological care. The faith in the Church, Bible and the spiritual leaders can play a role in whether the African Americans seek help through psychological services. The question of whether Christians should seek help outside the church has diverse responses, ranging from strongly agree to disagree strongly. Besides the participants who somewhat agree, there are many, 6 out of the 22 participants, who strongly oppose. Similarly, there are 8 out of the 22 participants who strongly

60 disagree with the use of psychology in the church. The data shows that a firm belief in the religious doctrine could be a hindrance to the people from seeking psychological care. Potentially, the stronger the faith, the more distrusting the Black Americans gets the mental support principles. Participants statements from the qualitative exclusion survey regarding characteristics which are undesirable and desirable in achieving increased retention and sought out services psychological care are as follows: “They should be a good listener, and smart.; The person would have to be Afro-American, and have the same faith I have; The person would have to have strong beliefs in the word of the Most High, a knowledge of the history of oppression that my people experience here in this country, and what the says concerning why my people experience their Hardship; The person would have to be very well-versed in biblical doctrine; and if i was to seek services the person i would chose to see must be a bible believer.” Hence, active faith is an undesirable characteristic in achieving increased retention and seeking out services psychological care. The results, hence, suggest that the most desirable characteristic is a less belief in the power of the spiritual teachings. If the Black Americans did not have the church to run to when faced with stressful life events, they would seek out help outside the church. Another desirable trait is the knowledge of the history and principles of psychology. From the table 7 below, most of the participants, 7 out of 22, strongly agree that the culture would form the foundation for their trust in psychological support.

61 Table Seven Do you think it’s important to understand the history? of psychology before you agree to its services? Strongly agree Somewhat agree Neither agree nor disagree Somewhat disagree Strongly disagree Total

Percentage 77.27% 9.09% 9.09% 4.55% 0% 100%

Count 17 2 2 1 0 22

From the table, it emerges that creating more awareness among the Black Americans would play an essential role in their propensity to seek services outside the church for their psychological needs. In another question, 14 out of the 22 (63.64%) participants confirmed that understanding the history of psychology would impact their opinion to use psychological services. Through knowing what the services entail, there will an increase in the number of those seeking the services. The Participant’s Level of Decision Making Will Be Positively Associated with Their Spiritual Needs From the data collected from the participants, it emerges that religion and spirituality assumes an essential place in the lives of the Black Americans. Most of what goes on in the lives of these people have a spiritual implication. When they are faced with stress, they tend to have a spiritual explanation for the situation. Participants statements from the qualitative exclusion survey regarding participant’s spiritual needs will positively impact their need to seek psychological services are as follows: “They should be a good listener, and smart.; The person would have to be Afro-American, and have the same faith I have; The person would have to have strong beliefs in the word of the Most High, a knowledge of the history of oppression that my people experience here in this country, and what the says concerning why my people experience their Hardship; The person would have to be very well-versed in biblical doctrine; and if I were

62 to seek services the person I would choose to see must be a bible believer.” By reading through their history and the present experiences, spirituality developed as a means of coping with the hardships that they have experienced in the country, and they perceive discrimination in various aspects of their life. Hence, their spiritual needs are the basis for the decisions they make to seek help when undergoing stress and life pressures. The evidence is revealed in their acceptance of spirituality as being their place of refuge when they are facing problems. From the study, it became evident that the participants make their decisions based on what they have been taught in the Church. It is the reason most of them tend to pray any time they are facing any difficulties. They also choose to go to church when life appears challenging. They also depend on the counsel of their religious leaders in making decisions that affect their lives. Fasting is typical behavior among the blacks who attend the church from where the study was carried out. They believe that God has the answers and solutions to all problems they face in life. It is because they make decisions that are guided by spirituality. Participant’s Spiritual Needs Will Negatively Impact Their Need to Seek Psychological Services Much of the help for the Black Americans is available in the church. The reality is indicated by the fact that they associate all their problems with spirituality. When they are experiencing spiritual needs, it is less likely that they will seek help from outside the church. Psychological services are not a part of their religious traditions. In the church, they are taught that God has all the answers to their problems; therefore, it does not help to look outside the church for further assistance. The members of the community have no explanation for their issues that are outside the spiritual realm. Participants statements from the qualitative exclusion survey regarding participant’s spiritual needs will negatively impact their need to seek

63 psychological services are as follows: “I believe it’s ungodly; I don’t believe in it; I think seeking God is best; It makes no sense to pay someone just to talk about my problems; Indifferent.” Their belief system has an adverse effect on their chances of seeking psychological services. They will prefer to seek help from their religious leaders or pray instead of getting help from a mental health expert. The participants indicated that all their needs in life are spiritual. They indicated that they do not suffer from problems that are not under the control of their creator. Hence, the solutions are divine in nature and will be achieved through praying and fasting. Since the needs are spiritual, they are less likely to seek help from any other source. When deciding to seek help, the most likely direction is the Church and not the office of a therapist or a healthcare facility. The tendency to associate all problems with spiritual needs continue to affect the propensity to seek psychotherapy services. After all, they feel that the solution is not available there. Summary This chapter presents an analysis of the data collected to test the hypothesis and answer the research questions. All the six questions were responded to, and the two-hypothesis proven to be valid. The results indicate an innumerable amount of psychological needs of the Black Americans which are unmet because they tend to shy away from seeking or maintaining psychological services. The members of this population remain untrusting of the services or instead choose to request services from the church for their psychological needs to be met. The results lead to the discussion and conclusions presented in the following chapter.

64 CHAPTER FIVE: DISCUSSION, CONCLUSIONS, AND RECOMMENDATIONS Discussion The study indicates a clear relationship between spirituality, religion, and psychological health (Pirutinsky, Carp & Rosmarin, 2017). Because of the life stressors, African Americans suffer more mental health challenges than the general population. The population has experienced a challenging past and even the current situation has not improved much (Henderson, 2016). However, they remain the least likely people to seek help for psychological issues. They make up the least group of individuals seeking psychotherapy for mental and emotional problems. The data collected from the 22 African Americans indicate that their religious beliefs are influential factors in their use of psychotherapy services. Besides their beliefs, there is inherent mistrust towards the services, which are greatly viewed as being discriminatory (Brambilla, Manzi, Regalia & Verkuyten, 2013). The model upon which the services are designed is western and does not consider the unique cultural needs of this population. Because of the avoidance of the services, most of their psychological needs remaining unmet. At the same time, the spiritual needs of the population are not met because of the tendency to equate all the issues they experience with spiritual reasoning. The theoretical principle upon which psychotherapy is based is incongruent with the African Americans (Cokley et al., 2014). It does not fit into their cultural beliefs, explaining why it cannot be effective in meeting their needs. The various aspects of the American society, including the church are westernized, thus discriminating. However, there is the black church which goes well with the black culture (Plunkett, 2014). The religious groups are used as the basis for dealing with the most serious psychological needs.

65 The teachings of the Bible are not the basis for the current psychotherapy practices, which explains why they are not effective in helping the members of this community. At the same time, the theory and practice of psychotherapy are discriminatory in nature, and do not go well with the needs of the African Americans (Nadal, Griffin, Wong, Hamit & Rasmus, 2014). When making the decision based on their needs, they tend to favor spiritual or religious help. Important changes are required based on cultural congruent therapeutic practices. Both spiritual and psychological needs will be met when psychotherapy principles will incorporate the religious beliefs of the target population. It is possible for the blacks to be more involved in psychotherapy if the services appear to be more congruent with religious beliefs. The psychological needs faced by the African Americans are the same as those experienced by any other Americans. However, due to their history of hardship, they experience more stressors than the general population. Regardless, research indicates that the members of this community shy away from psychotherapy as the intervention for their mental health challenges. Many African Americans remain reluctant to seek help from psychologists which is the reason most of their psychological health needs remain unmet. Qualitative exclusion criteria survey showed that 12 out of 22 participants would never attend any therapy sessions; 6 out of 22 agreed to participate in psychological services and 4 out of 22 were undecided. The subjects have indicated a myriad of issues that they believe could be addressed in the church, but which remain unaddressed because the lack of scientifically proven effectiveness of this source of help. From the data analysis, it is evident that there are many issues among the African Americans that are not met through psychotherapy, the main reason being the evidence of mistrust with the clinical practice. The theory upon which psychotherapy is founded is not in line with the cultural and spiritual beliefs of the African Americans. Participants statements from the qualitative

66 exclusion survey are as follows: “I don’t believe in the use of psychotherapy: As old as I am what I’ve done so far works efficiently; because prayer usually works for me when I’m in that place of concern; and I believe that the Most High can assist me in whatever problem i have.” Given the strong reliance on the spiritual beliefs in a time of stress and other life pressures, it becomes clear that there are needs that are met through any other means including psychotherapy. This research shows the long history of blacks being discriminated agents and forced conversations within the Christian church as shone in chapter two, whose foundations lie in the European culture which has a strain on this targeted population. The Black Americans were inducted in a Christianity version that was against their traditional beliefs. The beliefs have been founded on a racial discriminatory view of the blacks. The doctrines excluded the blacks from fully participating in the Christian faith. This is even though their spirituality remains an important part of their decision making about various issues that affect their lives. Discrimination in the church is as common as in any other part of the society, as the research results reveal. The church is expected to be the place where equality is boosted, but this has not been the case. From the study, it becomes evident that the members of the Christian church have faced a kind of treatment which is unlike what the mainstream Christians go through. An evidence of the discrimination is indicated in the fact that the church where the research was carried out is primarily for the blacks. It shows that the members of the African American community do not feel comfortable or that their needs are being met in the churches of the whites. At the same time, their spiritual, emotional and psychological needs would not be met outside the black church. Conclusions Important conclusions can be made from the findings of the study. Spirituality and religiosity are critical aspects of the lives of the African Americans, this in turns shapes their

67 worldview regarding how they would seek and continue along with psychological services. They have developed as a means for coping with the stressful and unfair treatment as citizens within the historical confines of American history. Because of discrimination and the propensity to rely on religion, there is an evident distrust towards psychology (Mannheimer & Hill, 2015). They tend to make decisions relating to their mental problems based on their spiritual needs. Research shows the tendency to have a spiritual explanation for all the emotional and mental problems affecting the members of this population (Nie & Olson, 2016). Because of this, they will not go for therapy from a professional psychotherapist because of the lack of religious foundation. Therefore, to make the services more appealing to this population, it is critical to make them more culturally congruent. This is the way to ensure that more people are seeking the professional and effective services instead of only depending on the church. Implications for Practice For the psychiatrists, it is rewarding to provide care to people from diverse backgrounds. The same applies to African Americans. From practice, it is evident that although the members of this population are the most affected by mental problems, they are the least represented in psychotherapy. The problem needs to be addressed if more people will get the help they require to deal with life stressors. Finding a solution to make them more trusting of psychotherapy would play an important role in their care-seeking behavior. As a result, there could be less of those struggling with mental health issues. It could also save the cost of care for those who seek the services when their problems have progressed to levels that are hard to manage. In most cases, the African Americans will run to church for all their problems, until they escalate to an extreme point. It is at this point that they seek professional help (Sternthal, Williams Musick & Buck, 2012). Preventing such occurrences will save the resources used up by the individuals and the health care

68 system. It will play a role in reducing the work for the service providers and improve satisfaction for both the providers and the patients. Recommendations for Further Research The current study looks at the factors underlying the low turnout of the African Americans seeking psychological health services. Lack of trust of the services is one of the identified factors. The research does not look at the ways of making the services more favorable to this population. Thus, future research should be geared towards proposal for effective psychological interventions for the African Americans. It is important to move from the point of knowing the reason to proposing a solution. Future research will be critical in establishing the kind of interventions that will increase the number of African Americans seeking help for psychological problems.

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83 LIST OF TABLES Table 1 below shows the age distribution. From the analysis of the data n=22. This means that the total number of participants in the study was 22. The participants met the screening criteria based on the inclusion criteria survey. All the 22 (100%) Table One Age bracket 10-20 21-30 31-40 41-50 51-60 61-70

n=22 3 4 5 6 2 1

Table 2 is based on Relationship Status. From the study, the number of males was 8 (36.36%), while there were 14 (63.64%) females. In terms of biracialism, 11 (50%) of the participants agreed to be biracial, while the other 11 (50%) disagreed with the fact that they were biracial.

Marital status Single Married Divorced Serious relationship Widowed Other total

Table Two Percentage 36.36% 4.55% 22.73% 22.73% 9.09% 4.55% 100%

count 8 1 5 5 2 1 22

84 Table 3 The Level of Education of the participants. From the table, it is evident that many of the participants were single, 8 (36.36%). The number of the divorced participants was equal to those who were in a relationship, 5 (22.73%). The widowed participants were only 2 (9.09%). The number of married participants was the least with only one member. From the data, most of the participants had attained some degree in education.

Level of education Less than high school High school Diploma/ GED Some college AA degree Bachelor’s degree Master’s degree Doctoral degree Total

Table Three Percentage 4.55% 4.55% 36.36% 13.64% 18.18% 18.18% 4.55% 100%

Count 1 1 8 3 4 4 1 22

Table 4 below shows Level of Income Data. In terms of the level of income, most of the participants 8 (36.36%) earn $30-50K a year. Those who earn $ up to 15K a year and $50-70K a year were equal in number at 4 (18.18%). Only 3 13.64% earn $15-30K a year and $70+ a year. The financial capability of the individual might play a role in where the person gets services for various needs in life. The table shows that the level of income for many of the participants is in the middle of both extremes

Table Four Level of income $ up to 15K a year $15-30K a year $30-50K a year $50-70K a year $70+ a year

n=22 4 3 8 4 3

85 Table 5 Shows the Reason Why Some Needs of the African Americans Cannot be Met Through Psychotherapy The results of the research show that most Black Americans do not believe in utilizing psychological services. The research shows their apprehension conflict with their values or worldview of therapists can lead to ambivalence about seeking help. The table reflects that 54.55% agree and 36.37% disagree the fact that bible believers should seek assistance proving that more should be done to bridge the gap reflecting the populations apprehension to receive services.

Table Five Do you believe bible believers should use psychological services for mental health needs? Percentage Strongly agree 22.73% Somewhat agree 31.82% Neither agree nor disagree 9.09% Somewhat disagree 4.55% Strongly disagree 31.82% Total 100%

Count 5 7 2 1 7 22

Table 6 The Most Effective Biblically Based Theories Utilized to Provide Psychotherapy to Black Americans. The relationship with God for the African Americans is a huge part of their belief system. From the study, 20 (90.9%) of the participants strongly agreed with the observation. Thus, it is evident that considering the relationship would improve their trust with psychotherapy. To be more successful, the interventions should be founded on the faith and cultural beliefs of the participants. From the question, does your faith helps you deal with problems you face in life problems, 17 (77.27%) of the participants strongly agreed It will also be helpful if psychotherapy interventions are based on spiritual leadership. Table 6 provides a clear indication of the reality. From the data, the spiritual leadership plays a critical role in their emotional and psychological support. As a

86 result, they will most likely go for psychosocial help if they are based on their religious beliefs and religious guidance.

Table Six Do you believe bible believers should seek assistance? for their psychological needs from a pastor? Percentage Strongly agree 45.45% Somewhat agree 18.19% Neither agree nor disagree 27.78% Somewhat disagree 9.09% Strongly disagree 0% Total 100%

Count 10 4 6 2 0 22

Table 7 the Importance of understanding the history of psychology before agreeing to services? The question on whether Christians should seek help outside the church has diverse responses, ranging from strongly agree to strongly disagree. Besides the participants who somewhat agree, there are many, 6 out of the 22 participants, who strongly disagree. Similarly, there are 8 out of the 22 participants who strongly disagree with the use of psychology in the church. The data shows that a strong belief in the religious doctrine could be a hindrance to the people from seeking psychological care. From the table 7 below, most of the participants, 7 out of 22, strongly agree that the knowledge would form the foundation for their trust in psychological support. From the table, it emerges that creating more awareness among the African Americans would play an important role in their propensity to seek services outside the church for their psychological needs. In another question, 14 out of the 22 (63.64%) participants confirmed that understanding the history of psychology would impact their opinion to use psychological services. Through knowing what the services entail, there will an increase in the number of those seeking the services.

87

Table Seven Do you think it’s important to understand the history of psychology before you agree to its services? Strongly agree Somewhat agree Neither agree nor disagree Somewhat disagree Strongly disagree Total

Percentage 77.27% 9.09% 9.09% 4.55% 0% 100%

Count 17 2 2 1 0 22

88 LIST OF FIGURES Negroland and Guina

89

APPENDICES

90 APPENDIX A Consent Form

91

92 APPENDIX A Consent Form Upon the participant's completion of the survey, a reminder of services can be provided due to any feelings of discomfort after completion of surveys, with numbers to counseling or pastoral staff members. Lastly, an informed consent will provide contact information of the researcher and dissertation chair for any questions or concerns regarding the study.; 2 pages in the appendices consecutively.

93

APPENDIX B Informed Consent

94

95 APPENDIX B Informed Consent Form Informed consent includes guidelines consisting of four components: (a) background of to the research; (b) the demands for the participants; (c) questions about participants? consent; and (d) official guidelines; 2 pages in the appendices consecutively.

96 APPENDIX C Demographic Questionnaire

97 APPENDIX C Demographic Questionnaire The background and demographic information was obtained through the online questionnaire the demographic facts research consists of: age, gender, biracialism, relationship status, highest level of education, and income status; 2 pages in the appendices consecutively.

98 APPENDIX D Exclusions Criteria Survey

99 APPENDIX D Exclusions Criteria Survey The qualitative exclusion criteria survey is an in-depth survey were the needs of clients are defined using the open- and close-ended questions to wen out a selection of five to seven participants. 1 page in the appendices consecutively.

100 APPENDIX E Quantitative Survey

101 APPENDIX E Quantitative Survey A Likert formal survey applied to identify the participants' perceptions about the importance of their spirituality and how they perceive mental health programs should reflect their personal values; 1 page in the appendices consecutively.

102 APPENDIX F Flyer

103 APPENDIX F Online Flyer Online flyers were used through online generated event platform; 1 page in the appendices consecutively.

104 APPENDIX G Recruitment Email

105 APPENDIX G Recruitment Email Recruitment email through Qualtrics online recruitment service platform; 1 page in the appendices consecutively.

106 APPENDIX H Study Debriefing

107 APPENDIX H Study Debriefing Upon the participant's completion of the survey, a brief statement of debriefing was displayed. To remind them that the survey is confidential, who to contact if they have any questions, and a contact if they should want to request a copy of the summary results. A reminder of services can be provided due to any feelings of discomfort after completion of surveys, with numbers to counseling or pastoral staff members.; 1 page in the appendices consecutively.

108 APPENDIX I Certificate of Participation I

109 APPENDIX I Certificate of Participation I A certificate of participation of presented immediately following the debriefing statement.; 1 page in the appendices consecutively.

110