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Abstract

Issues in mental health treatment for black women are multiplicative, significant, and often controversial. As black women increasingly seek professional mental health services, it is imperative that social work practitioners utilize strategies that are based on culturally congruent mental health paradigms that illuminate their strengths and recognize the deficits in the environment. Black feminist therapy has been identified as one such method. Black feminist therapy can mark a beacon in mental health practice, theory, and inform a political movement in the combating of their complex and multiplicative oppressions. This column serves as a call to action to the profession.

Keywords

black feminist theory/womanism mental health social work practice

Introduction

As a social work scholar and practitioner, I am often absorbed by the reoccurring question offered by Toni Cade-Bambara’s (1980) The Salt Eaters: “Are you sure, sweetheart, that you want to be well?” This question calls for understanding that, in order for black women to achieve psychosocial wellness, they need safe spaces where they can share their stories, be heard, recover from psychosocial traumas, and create strategies for change. These spaces often exist in contexts where Black women feel free to sort out their personal struggles from the structural constraints of racism, sexism, classism, and heterosexism and can discover holistic wellness (mental, physical, and spiritual). Black feminist-centered, therapeutic models are one such space. Black feminisms place African American history and culture at the center of the lives of women of African descent. They provide an intersectional framework that emphasizes a holistic integration of race, ethnicity, culture, and gender identities that are related to black women’s lived experiences (Settles, 2006). Further, black feminisms speak to the importance that both the changed consciousness of individuals and the social transformation of political and economic institutions constitute essential ingredients for psychological and social change for all women. This perspective is offered as an alternative to traditional mental health treatment that often views black women as “other” and whiteness, maleness, heterosexuality, and middle-class status as the “norm” (Jackson & Greene, 2003).

In search of scholarship on these models, I poured over the social work literature, looking for insight on the use of black feminist perspectives in practice, only to be faced with the daunting reality of the lack thereof. There is, however, a plethora of scholarly literature on black feminisms in psychology, women’s studies, and political science. “How can this be, who will lead the way in social work?” I asked myself. My initial response was anger, followed by disappointment…disappointment in the exclusion, the silence, the misuse, and the betrayal. My disappointment, however, is loaded with energy: energy gleaned through the work of practitioner, academic, and literary black feminists; pioneers like Cheryl Clarke, Lillian Comas-Dias, Lenora Fulani, Paula Giddings, Beverly Greene, Lorraine Guttierrez, Beverly Guy-Sheftall, bell hooks, and Elaine Pinderhughes, whose body of work transcends universalizing, hierarchical, and dualistic limitations of feminisms. I use this energy as a feminist scholar-activist to identify and rectify gaps in the social work practice literature, in order to address the life concerns and possible futures of black women. This column is a call to the profession. I argue that the use of black feminist perspectives in social work practice provides an ideal framework for services that are responsive to the multiplicative health needs of black women.

Black Women, Utilization, and Service Needs

Over the past two decades, the importance of culturally congruent services has gained support from federal initiatives, which have focused on advancing research that addresses racial and ethnic minority health and mental health disparities. These include strategic plans, career development programs for researchers from underrepresented groups, requirements for enrolling minorities in clinical trials, and most recently, the establishment of the National Institute on Minority Health and Health Disparities. As black women increasingly make a concerted effort to seek out professional mental health services, research posits that they are less likely to obtain professional care (Alergria et al., 2002; Jackson & Greene, 2003). When they do seek care, it is often after considerable delay when they have reached a crisis point and are more likely to be misdiagnosed (Carrington, 2006). Additionally, they withdraw from treatment early because their ethnic, cultural, and/or gender needs go unrecognized or mistreated (Blazer, Hybels, Simonsick, & Hanlon, 2000; Greene, 2004; Jackson & Greene, 2003; Ward, Clark, & Heidrich, 2009; Warren, 1994). One consistently highlighted shortcoming is that mental health treatment models are culturally inadequate, specifically lacking the depth to address the multiplicative oppressions associated with racism, sexism, classism, heterosexism, and all other forms of oppression (Comas-Diaz, 2010; Greene, 2000; Greene, Boyd-Franklin, & Spivey, 2013; Jackson & Greene, 2003). It is posited that treatment models are based on racist–patriarchal conceptions and suggested that new models must be initiated to accommodate the pressing needs of women across all racial, ethnic, and cultural backgrounds (Comas-Diaz, 2010; Greene, 2004; Sue & Sue, 2013).

The field of social work has progressively given attention to the needs of diverse groups through the cross-cultural practice literature, with the intention of rethinking practice frameworks and adapting existing practice models to serve women and people of color (i.e., Comas-Diaz, 2010; Ho, 1994; Lum, 2011; McGoldrick, Giordano, & Pearce, 2005; Pinderhughes, 1989; Sue & Sue, 2013). In short, cross-cultural practice efforts equip practitioners with cultural knowledge about race, gender, and class, aimed at increasing cultural literacy to improve the level of understanding that mental health practitioners bring to their work with clients from different cultures (Husband, 2000). Although this attention is a step in the direction toward cultural sensitivity, it overlooks the importance of developing and utilizing practice interventions that reflect the lived experiences of black women. In response to this challenge, a small number of black feminist scholars and practitioners, including myself, have increased their efforts to challenge the universalizing limitations of feminist therapies to be more inclusive of race, class, and sexual orientation. These include, but are not limited to, Nancy Boyd-Franklin (2003, 2010), Lenora Fulani (1988), Beverly Greene (2008), Vanessa Jackson (2010), Leslie C. Jackson & Beverly Greene (2003), Lani V. Jones and Ford (2008), Vickie Mays (1985), Carolyn M. West (2002), and Carolyn Braun-Williams (1999).

Feminist therapy emerged in the 1970s as one of the responses to second wave feminism, which among many issues was focused on guaranteeing social and economic equality, regardless of gender. The practice of feminist therapy is informed by feminist political philosophies and analysis, grounded in feminist scholarship on the psychology of women, men, and gender identity. It advocates for gender-neutral and sensitive approaches that put gender and power at the center of the therapeutic process. Feminist therapies are not traditional therapies with gender awareness added; rather, they are a complete transformation of the way in which therapy is understood and practiced (Brown, 2010; Enns, 2012; Jackson & Greene, 2003). Different from traditional therapeutic modalities, feminist therapies are influenced by a gender analysis of patriarchal society and provide a mode of empowerment for women as an oppressed group. Hence, feminist therapy may involve interventions that acknowledge sex role difference, female socialization, and women’s minority status in a patriarchal society as sources of psychological difficulty (Brown, 2010; Enns, 2012; Israeli & Santor, 2000). Feminist therapy further argues that women’s mental health cannot be made holistically “well” within the micro context of therapy alone but only while making simultaneous effective structural changes to societal institutions. As a result, feminist therapists may engage in social activism as well as assist word choice—consumers to build skills of self-advocacy to interrupt oppression not only in their daily lives but also systemically. For example, in working with poor women/men, the practitioner may go beyond exploring the consumer’s basic needs and psychological impact of poverty by acknowledging the societal feminization of poverty and exploring ways in which the consumer can become involved in equal housing access forums.

Although feminist therapy has become a viable treatment option for women, having risen dramatically from receiving almost no attention to a position of considerable popularity, of concern is the lack of attention to the integrated realities of black women in the practice of and research on feminist therapy. Scholars argue that feminist therapies have historically excluded and devalued the experiences of black women and that there have been misguided interpretations of their realities at the conceptual, theoretical, and methodological levels (Brown, 2010; Fulani, 1988; Jackson & Greene, 2003; Vaz, 2005). In particular, feminist therapies have been criticized for their limited focus on the cultural context of white middle-class women and the exclusion of women of color and other oppressed groups such as black women (Boyd-Franklin, 2003; Brown, 2010; Comas-Diaz, 2010; Greene, 2004; Williams-Braun, 1999). The argument is that these practices often reinforce the same racial discrimination and sexist denigration that have often brought black women into treatment in the first place. Hence, we arrive at a place within the 21st century where the field of mental health is faced with the critical task of providing culturally relevant services to women who were, and continue to be, routinely ignored by the dominant feminist movement.

Twenty-First Century Practice: A Time for Radical Transformation

Black feminist therapists adopted an urgent mandate to address all forms of marginalization and discrimination simultaneously, instead of privileging gender issues alone, arguing for processes and methods that reflect the multiplicative oppressions faced by women within their social–cultural contexts (Sparks & Parker, 2000). These are processes and methods that offer more complex conceptualizations of gender and its intersections of difference and incorporate a fundamental understanding of black women’s historical, sociocultural, familial, and developmental heterogeneity. This perspective recognizes different ways of seeing black women’s reality from a positive standpoint and helps to forge a greater understanding of their strengths, resilience, and struggles.

The use of black feminisms as a philosophy in therapy intentionally acts as a strategy that gets to the heart of those inequalities suffered by black women. Black women’s historical struggles and the emphasis on “the personal is political,” emotional wholeness, empowerment, and social change are at the core of black feminist therapeutic practices. These principles represent themes that emerge from the black feminist literature, the lived experiences of black women in the United States, and resonate with the work of black feminist practitioners in the field (Boyd-Franklin, 2010; Williams, 2005; Greene, 1997; Jackson, 2010; Jones & Ford 2008; Vaz, 2005).

Black feminisms in therapy are not a set of therapeutic techniques but a lens in which to view the world (worldview), a value of responsiveness, and a political and aesthetic epicenter that informs practice. However, there is consensus among many black feminist therapists about some of the structural elements of the therapeutic process. Structural elements include but are not limited to a negotiation of fees, accessibility of space, minimization of power differentials, acknowledgment and valuing of Black women’s experience, recognition of the impact of the multiple oppressions on the consumer’s experience, and sensitivity in the naming and diagnosing of problems/issues. Black feminists have also restructured the practice of therapy through the deep integration of consciousness raising, exploration of their multiplicative and compounding life stressors and circumstances, race–gender role analysis, backing of their prioritizing of self-care over those of others, insistence in the lack of minimalizing of one’s pain, strategizing against competing life demands, and an exploration of how black women’s concepts of citizenship affect their political engagement.

Explanations as to how black feminist perspectives are integrated into the ongoing dialogue of therapy are limited but somewhat more valuable are numerous examples of black feminist thought and interventions in the context of that therapy (Boyd-Franklin, 2010; Comas-Diaz & Greene, 1994; Collins, 1990; Guy-Sheftall, 1995; Greene, Boyd-Franklin, & Spivey, 2013; Jackson, 2010; Jackson & Greene, 2003; Jones & Warner, 2011; Taylor, 1998). Examples of the usefulness of the black feminist perspectives in mental health and substance abuse treatment can be found in the literature. For instance, Roberts, Jackson, and Carlton-LaNey (2000) discuss the use of a black feminist therapeutic approach that assists drug-abusing black women to explore the negative controlling images of mammy, matriarch, welfare mother, and jezebel. They analyze how these images have been used to make racism, sexism, and poverty appear natural, normal, and as an inevitable part of everyday life for African American women. Utilizing principles of consciousness raising, these women are able to gain an understanding of these negative societal images and participate in a redefinition of the self as a source of empowerment in recovery. Jones and Warner (2011) utilized an evidenced-based, culturally congruent intervention grounded in black feminisms and psychosocial competence perspectives to reduce depressive and stress symptomatology, decrease externality of locus of control and increase active coping among black women in shelter, substance abuse, and mental health programs. In this 10-week group treatment program, a theme that emerged was internalized racism and sexism and its resulting psychosocial stressors. Participants engaged in an exercise entitled “healing truth” aimed at exploring one’s race–gender roles. Participants examined their collusions with expectations of being a “strong black woman,” engaged in a race–gender role analysis and discussed the ways in which these roles impacted their psychological and physical functioning. Williams-Braun (1999) advocates for an integrative approach to working with black women through an examination of the psychological, social, and cultural context surrounding their search for wellness. She utilizes a black feminist therapeutic technique to assist women in drawing connections between their difficulties and the historical experience of African American women. These connections provide a context for the consumers to share their stories of emotional taxation and help them to externalize the source of the problem rather than view themselves as incapable of actively coping. Additionally, writings on black feminisms have examined the interaction and multiplicative interactions of race, gender, class, and sexuality in black women’s lives, which also may be a useful resource (Boyd-Franklin, 2010; Greene, 2008; Jackson, 2010; Rhodes & Johnson, 1997).

Recommendations

The appropriate use of black feminist therapies with black women requires literacy and competence on the part of practitioners, academics, and researchers. The following recommendations are suggested for comrades and allies interested in utilizing the black feminist perspective in social work education and practice.

Social work feminists and allies must have the courage to discuss and document their work on black feminisms in the practice literature and in public forums, such as at conferences and other convening’s on mental and social health. Social workers in the academy should participate in continuing education programs that seek to enhance their practice skills and competency in the black feminist perspective.

Social work practitioners must acknowledge their own value system and its potential impact on the ability to maintain an empathetic and therapeutic relationship with Black women in practice. Specifically, practitioners must be tuned-in to diversity and its centrality to the ways in which his or her own values shape the therapeutic process.

Social worker practitioners must possess a willingness to validate the perceptions of racism, discrimination, and bias black women have experienced in mental health and social service agencies, providing a space in which black women can re-story their identified problems, without feeling invalidated or dismissed.

Conclusion

Black feminist therapy has the possibility to represent a beacon in social work practice and to serve as a political movement in combating the complex and simultaneous oppressions and psychosocial stressors that black women face. Such practice methods would not only help black women reconstruct negative societal self-images constructed by patriarchal therapeutic ideologies but also assist them in consciousness raising regarding their socially constructed identities and to reject socially induced shame and degradation. Hence, the incorporation of black feminist practice perspectives that raise consciousness, foster resilience, and empower Black women will serve to decrease psychosocial stressors and promote positive coping strategies (Boyd-Franklin, 2003; Greene, 2004; Jones & Ford, 2008; Vaz, 2005). Further, this perspective in social work will assist in cultivating modes of empowerment that black women may utilize in the development of positive mental health outcomes. These can include realization of one’s potential, positive coping strategies, better quality of life, and positive influence on lifestyle and behavior (Greene, 1997; Jones & Ford, 2008; Taylor, 1998; Thomas & Gonzalez-Prendes, 2009).

Integral to the success of black feminisms in social work practice is the profession’s full-fledged commitment to creating positive mental health outcomes through its development of treatment protocols, delivery of services, and reaffirmation of its values. This can promote equity and social justice for black women and provide an invaluable framework for social work practice and research for all oppressed groups.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

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Black Feminisms

Abstract

Keywords

Introduction

Black Women, Utilization, and Service Needs

Twenty-First Century Practice: A Time for Radical Transformation

Recommendations

Conclusion

Footnotes

Declaration of Conflicting Interests

Funding

References