Employing Nonstandard Therapeutic Tools
The question of whether standard psychotherapeutic approaches are as efficacious in African American patients with a variety of mental disorders (compared with the largely white population for whom those approaches were developed) continues to be studied. [Surgeon General Supplement, 2001] The answers to that question show that
for some mental disorders in some study groups standard therapies are comparably effective in African Americans vs white Americans, while for other disorders they appear to be less effective. Examples include:
- Two studies by Rosenheck and colleagues and Zoellner and colleagues of patients with post-traumatic stress disorder (PTSD) indicated that African Americans and white Americans experienced similar treatment responses. [Rosenheck 1994, Zoellner 1999]
- Investigations by Friedman and colleagues and Treadwell and colleagues reported the cognitive-behavioral therapy, which aims to modify patients thought patterns toward more positive directions, was equally effective in reducing anxiety among African American and white children and adults. [Friedman 1994, Treadwell 1995]
- By contrast, in a pilot study Chambless and colleagues found that African Americans were less responsive than white Americans to behavioral therapy for agoraphobia. [Chambless 1995] And Brown and colleagues reported, in another study of treatment for anxiety, that African Americans and whites had similar responses to treatment with psychotherapy and medication, except that African Americans showed less improvement in their ability to function in the community.[Brown 1999] Finally, Williams and colleagues demonstrated that exposure therapy—ie, overcoming fears through graduated steps—was not effective in treating panic attacks among African Americans. [Williams 1994]
This very brief overview of the efficacy of several widely used psychotherapy approaches for common mental disorders indicates that for many African American patients, different therapeutic methods with attention to culture-specific components may be more useful.