The African American experience of overcoming barriers and participating in therapy

Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)


Marriage and Family Therapy


Jonathan G. Sandberg


African-American, Therapy, Engagement, Qualitative, Barriers to therapy

Subject Categories

Clinical Psychology | Family, Life Course, and Society | Race and Ethnicity | Social and Behavioral Sciences | Sociology


The Marriage and Family Therapy field has come to recognize and appreciate the diverse racial and ethnic makeup of families. While there have been a growing number of articles written about African Americans, there is limited empirical research published to clarify, refute, or support the best practice strategies being suggested. This dissertation is a step in the direction towards clinically relevant research with African Americans. The therapeutic literature has identified that African Americans are underrepresented in therapy, utilize it inconsistently, and prematurely dropout (Breland-Noble et al., 2006; Priest, 1991; Thompson et al., 2004). The aim of the study is to gain a clearer understanding of the African American experience of barriers to therapy, perceptions of overcoming said barriers and the experience in therapy. In addition, this study provides insight into African Americans expectations and experiences developing trustworthy therapeutic relationships.

Qualitative methodology employing a phenomenological approach was utilized to inquire about the research question. Nine in-depth interviews were conducted, and data were analyzed following Moustakas' (1994) recommendations. Results from the data revealed that participants had different understandings regarding their racial identification; indicating that racial identity and racial socialization are salient themes in the lives of African Americans. A unique finding of this study is the importance the male participants place on fatherhood. The findings suggest that the stigma associated with therapy continues to be a cultural barrier to family therapy that African Americans must overcome. In addition, once in therapy findings suggest that the development of a trustworthy therapeutic alliance is contingent upon African Americans initial assessment of safety in the therapy room. The findings of this study have considerable implications for working ethically and effectively with African Americans.


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