Thesis (Ed.D.)--Teachers College, Columbia University, 1966. / Typescript; issued also on microfilm. Sponsor: Esther Lloyd-Jones. Dissertation Committee: Gordon Klopf, Robert Dentler, . Includes bibliographical references (leaves 154-187).

Mental health disparity is an emerging national concern with evidence suggesting individuals from non-dominant populations are less likely to seek and persist in mental health services compared to their dominant culture peers. In particular, African Americans may underutilize professional counseling services due to factors such as stigma, healthy cultural mistrust, and cultural values. To date, researchers have paid limited attention to ways to break through barriers to mental health equity. The purpose of this phenomenological study was to explore African Americans’ experiences and decision-making seeking professional counseling services. I addressed the following questions: How do African Americans make meaning of their decision to seek counselor services? What considerations are involved in decision- making with African Americans who decide to seek professional counseling services? Participants included 10 African American women who had attended counseling with a licensed professional counselor (LPC) or LPC Intern in the past three years. I identified six emergent themes through adapted classic phenomenological analysis: feelings prior to attending counseling, coping mechanisms utilized prior to counseling, barriers to treatment, motivation to attend counseling, characteristics of counselor, and post counseling experiences. Participants reported increased personal growth, insight, and desire to recommend counseling to others. Findings inform communities about what counseling is (and is not) as well as different types of support that can be obtained from a professional counselor. Limitations and future research directions are discussed.

The utilization of counseling services by Black college students has been a focus of the help seeking literature. The help seeking literature has focused on the nature of the potential problem, attitude toward counseling, rank of potential helpers, characteristics of help seekers, and the characteristics that Black students most prefer when choosing to see a counselor. The majority of this literature has primarily focused on the differences between White and Black students while ignoring within group differences. The present study examined the help seeking attitude and counselor preference of Black college students. The following hypotheses were investigated: a) whether African self-consciousness, socioeconomic status, sex, cultural mistrust, and prior counseling experience would predict attitudes toward counseling, b) whether African selfconsciousness, sex, socioeconomic status, prior counseling , and cultural mistrust would predict counselor preference for personal concerns, c) whether African self-consciousness, sex, socioeconomic status, prior counseling , and cultural mistrust would predict counselor preference for educational/vocational concerns, and d)whether African selfconsciousness, sex, socioeconomic status, prior counseling , and cultural mistrust would predict counselor preference for environmental concerns.A regression analysis using SPSS revealed that socioeconomic status, sex, and cultural mistrust were statistically significant predictors of attitude toward counseling. Three separate canonical correlations revealed that African self-consciousness, cultural mistrust, and gender were significant predictors of race and gender preferences for personal, educational /vocational, and environmental concerns experienced by Black students. Generally, Black students who were culturally committed, as measured by African self-consciousness, preferred a Black female counselor when faced with personal, educational/vocational, or environmental concerns while those Black students who were less mistrustful preferred a White female counselor for these same concerns. Limitations and implications for theory, practice, and research of the findings are discussed / Department of Counseling Psychology and Guidance Services

Changing trends within the mental health system treatment practices demand exploration of the cultural context of assessment and treatment of Black/African Americans. Culturally competent assessments include a realistic integration of historical context. Clinicians counseling Black/African Americans must be prepared to assess and address PTSD, racial trauma, micro-aggressions, and other known (or unknown) issues that may affect Black/African Americans. In addition, clinicians must be prepared for the depth and permanence of race-based stress and trauma, as well as the idea that said stress and trauma can result from unaddressed environmental, familial, and/or individual factors. The purpose of this study is to explore cultural competence in the practices of clinicians working with Black/African Americans clients as it relates to assessment, treatment and engagement. Through the exploration of current multicultural counseling and assessment trends, the study explores the origins of stress and trauma in American descendents of African slaves, and proposes an evaluation of clinicians' mental health assessment for PTSD with said clients based on those implications. Exploring to what extent a culturally-proficient clinician engages Black/African Americans clients from initial through on-going assessment and treatment process in conjunction with the professional literature on treatment practices, research suggests that Black/African American clients do suffer from intergenerational trauma and are often mis- or under-diagnosed for mental health issues. With proper assessment of Black/African Americans, the reduction of misdiagnosed or under diagnosed cases of Posttraumatic stress disorder (PTSD), as well as other mental health conditions will occur. / Graduation date: 2012