James H. Williams, Ph.D., L.C.S. W. *


It has been estimated that, at any given time, more than 3 million Americans have an emotional condition that affects their ability to work or to seek educational opportunities. Our mental health delivery system indicates high rates of treatment attrition, noncompliance and relapse. Our present treatment system is based on the medical model, which : emphasizes client deficits. A model that takes client strengths into account may prove more successful. This paper examines the relation between the Afrocentric perspective and the Strengths Perspective in mental health treatment.


The Diagnostic and Statistical Manual of Mental Disorders IV - TR

.. of the American Psychiatric Association (2000) is the mostauthoritative and widely-used diagnostic tool for assessing mentally-disordered behaviors. It is the most recent in a long effort to develop typologies and categories of mental illness, The U.S. Census of 1880 listed seven categories of mental illness: mania, melancholia, monomania, paresis, dementia, dipsomania and epilepsy. Following World War II, an improved nomenclature was developed for the treatment ofWWIIservicemen and veterans. In 1952, the first edition of the DSM was published, followed by DSMII (1 968h DSMll (1980),DSMIIIR (1987) andDSMIV (1994), and DSM-IV-TR (2000). DSM-IV, which appeared in 2000, groups mental disorders into 16 major diagnostic classes, each with dozens of sub

* James H. Williams is an Associate Professor at Savannah State University.


categories and groups. It organizes information along five axes (DSM, 2000, p.l0).


Critics of the DSM argue that the DSM, like the "medical model" ingeneraI is a "deficitmodel" --simply a listing ofthlngs that are wrong with the patient or client. Here are some of the criticisms of the DSMmodel:

• The DSM does not assist in the development oftreatment strategies because it provides no guide to curative factors.

• The DSM gives no assistance in identifying patient-client strengths that could assist in treatment.

• The DSM saddles clients with "labels" that could be destructive, unhelpful and difficult to remove.

• The DSM provides no insight into "person-in-environment" or "person- in-situation."

• The DSM categories are rigid and inflexible. They imply discrete

categories, ignoring the possibilities of continuums of disorder.

At best, some critics argue, the DSM is useful as an instrument for garnering third-party insurance payments, as an educational tool, and as a means for developing a common language among treatment disciplines (Dziegielewski,2002,pp. 3-12; Brubeck, 1995,pp.121-135).

The Afrocentric Perspective in Mental Health Treatment

Some treatment providers view Afrocentrism with skepticism, dubiousness, andperhaps.alittle fear. It's truethatthe speeches and writings of some Afrocentrists can be a little "scary" to white people, who become defensive and resistant to insights found in the Afrocentric perspective. However, many of the insights developed by Afrocentric social scientists can prove useful in treatiugpeopleofcolorandoppressedandpowedesspopulations of all colors, Dr. Karengacreated theholidayofK wanzaabasedon these seven principles:


• Umoja(Unity)

• Kujichagulia (Self-Determination)

• Ujimaa (Collective Work and Responsibility)

.• Ujama (Cooperative Economics)

• Nia (Purpose)

• Kuumba (Creativity)

• Imani (Faith)

Most social workers would find little with which to quarrel in these principles. Afrocentric criticisms of the dominant or Eurocentric social perspectives are its "Individualistic) materialistic, mechanistic and pessimistic character. The individualistic focus is manifested in human

. service paradigms that spend an inordinate amount of time delineating and explaining individual traits/attitudes, personality dispositions and disorders, ego functions or dysfunctions or individual psychosocial crises .... there is.still a penchantto view the individual as a sort ofisolated, autonomous entity" (Schiele, 2000, p. 6). Schiele argues that to consider the individual without also considering the "person-in-environment" results,in a perspective that distorts diagnosis and inhibits construction of . an effective human service provision. This results in a treatment paradigm that is mechanistic and which relies on theories of unilinear causation

. (Schiele, 2000, pp. 6-7). Unilinear causation theory, Schiele argues, "imposes a deterministic view of human behavior, one that not only de emphasizes the possibility of reciprocity and interchangeability between cause and effect but ... also rejects the interaction of the material with the spiritual" (p. 8).

The focus of Afrocentric human services extends beyond the scope of people of African ancestry to address problems confronted by all people. Schiele (2000) says, from an Afrocentric framework, the problem of cultural oppression, for example) is believed to have adversely affected most people, the culturally dominant and the culturally oppressed. Consequently, Afrocentrism is not "ethnocentric" or "culturally chauvinistic" . hut emphasizes the importance of being grounded or centered in one's historical and cultural experience: "by liberating one group, we help make the world a better place for all because the world


becomes more inclusive of the optimal contributions of all" (Schiele, 2000, p. 23).

The use ofAfrocentristic perspectives (atleast, inmy comprehension) of treatment therefore follows some of these general principles:

• Holistic, treatingmind, body, and spirit

• Universalistic ( collective, encompassing) rather than Eurocentric (individualistic, narrow), open to all cultures and races

• Committed to social, economic, and health needs ofindividuals within a community setting, with a need for all to contribute to the community

• Recognizing the contributions and potential for growth and

change of all members of the community: a culture ofparticipation tatherthandomination

• Encouraging self-efficacy and self-help along with mutual aid

• Understanding the mutuality and humanity that governs the relationship between human service workers and clients, for example, working with clients, not/or clients.


These illustrate some of the similarities between the Afrocentric Perspective and the strengths-based perspective.

Solomon (1976) and Lee (2001) stressed the Empowerment Perspective which emphasized client strengths and saw the role of the social worker as facilitating and building upon those strengths. This in turn has similarities with the approaches of Epstein (1988), Perlman (1957), and Germain and Gitterman (1996) which emphasize the importance of using strengths and capacities learned in solving one set of problems in order to solve yet another set of problems. Martin and Martin (1995) emphasized the historical experience of solidarity within the African American community and its role in problem-solving.

Saleeby (2006), Rapp and Goscha (2006), van Wormer and Davis (2003), Glicken (2004), Poulin (2005), and others have championed the development of a strategy of social work practice which focuses upon the


strengths of clients," rather than weaknesses or deficits, and employs those strengths in problem-solving. As Saleeby states: "No matter how subordinated, marginalized and oppressed individuals and communities may appear, people, individually and collectively, can fmd nourishment for their hopes and dreams, tools for their realization somewhere" (Saleeby, 2006, p. 282). In practice, the strengths practitioner will fmd much in common with solution-focused methods, motivational. interviewing, and existential approaches such as that of Carl Rogers or Victor Frankl (1984).

The Strengths Perspective focuses on client resilience. In everyday life, people rebound from problems. Trauma, abuse, illness, and struggle may be injurious, but they may also be sources of challenge and opportunity. People who have learned to cope or survive can use those tools to solve other problems. The following are some of the characteristics of the Strengths Perspective:

• Every environment is full of resources. Every individual, family, group, or community has strengths.

• We serve clients best by collaborating with them. the deferential power relationship in a worker-client relation could be a barrier to treatment. Effective treatment starts with what the client sees as the problem and wishes to solve.

• Clients benefit from the instillation of hope. Some might call this the "placebo effect."

It may seem as though, in recapitulating these ideas, that we are simply restating obvious 'thorne truths" and core values of the social work . profession. Yet, sometimes we fail to honor those truths and values in our practice=especially in agen~y settings based on social control or in settings . employing the medical model.

Here are some practice perspectives for work with mentally ill populations:

• The person is not the disease. People are multifaceted and while they may experience deficits in one area of their lives, they may exhibit competencies in other areas.

• Starting "where the client is": letting the client decide what issue


he" or she would like to work on. Develop a cooperative, problemsolving relationship. The "miracle question."

• Using Motivational Interview (Miller) to help the. client develop the motivation to move through stages of change. The instillation of hope is a major factor in successful client outcomes.

• Help the clients to identify how they have solved problems in the past and how they might use that knowledge to solve future problems. Helping the client develop a sense of self-efficacy. Amplifying the "well" part of the individual.

.• Help the client develop achievable goals and provide support.

Help the client identify sources of support in the family, friends, and community.

Sometimesthepolicies,rules;regulations;and procedures of ouragencies can be barriers to effective treatment. Agencies,just as successful businesses, have to focus on "the bottomline." Is the "bottomline" measured by the success of ourclients--or is it based on some other measure? Can we do a "strengths assessment;' of our agencies in order to determine how we can do our jobs better? (Rapp & Goscha, 2006, pp. 201-213).

Best Practices

Increasingly, the experiences of the past decades have helped to illuminate the "best practices" that can help achieve better outcomes for mentally ill offenders. Recently, the Council of State Governments, the U.S. Department of Health and Human Services, and 110 expert panelists from around the country have issued a "National Consensus Statement" which summarizes the practices best facilitating recovery.

These are:

• Self-Direction: consumers lead., control, and exercise choice over their path of recovery;

• Individualized and Person-Centered: findingthetreatment paradigm most suited to the individual;

• Empowerment: giving consumers the power to choose from a


! i

wide range of options, and the right to participate in mental health program decision-making;

• Holistic: recovery encompasses an individual's whole life, and has mind, body, spirit, and community components.

• Non-Linear: recovery is not a step-by-step procedure, but one based on a continuum of growth and setbacks;

• Strengths based: recovery is based upon building on peoples' strengths, rather than their wealmesses or deficits;

• Peer Support: mutual support is seen as a key component in maintaining a program of recovery;

• Respect: community, systems, and societal respect for the mentally ill, especially those in the criminal justice system;

• Responsibility: only those programs that foster individual responsibility and self-care can carry the mentally ill on their journey of recovery;

• Hope: programs that provide hope and motivation offer the best chances for recovery. (SAMSHA, 2006)


It can be argued therefore, that employing a strengths-based perspective is. solidly in the tradition of Afrocentric treatment and additionally enjoys a developing reception from the evidence-based community.


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