AFRICAN-AMER. ALCOHOLICS.   Term Paper ID:18663 Click to get this paper

Essay Subject: Statistics, special problems in treatment, socioeconomics, cultural beliefs, social services, counseling.... More...

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Paper Abstract: Statistics, special problems in treatment, socioeconomics, cultural beliefs, social services, counseling. Paper Introduction: The rate of alcoholism among African-American women, that of their male counterparts, lacks consensus among numerous researchers, educators, and helping-profession practitioners. The number of attempts to assess African-American alcoholism have only recently grown, not all of which have demonstrated sound validity and reliability (Harper, 1986; King, 1986). Harper noted in his 1986 analysis of the literature that only 89 scientific articles out of 16,000 published over a 30-year period through 1984 discussed alcoholism and African-Americans. Of these, only 11 specifically addressed the African-American population. King discovered similar issues in his 1985 review of the literature on African-American alcoholism and problem drinking. The areas of incidence and prevalence; socioeconomic analysis; characteristics, practices and patterns relative to Text of the Paper: The entire text of the paper is shown below. However, the text is somewhat scrambled. We want to give you as much information as we possibly can about our papers and essays, but we cannot give them away for free. In the text below you will find that while disordered, many of the phrases are essentially intact. From this text you will be able to get a solid sense of the writing style, the concepts addressed, and the sources used in the research paper. There are no clear, replicated research findings evidenced in theliterature which indicate one, sole variable resulting in alcoholism inAfrican-Americans. Alcoholism Treatment and Black Americans. In supportof this, Westermeyer (1986, pp. The issue of cultural beliefs as regards African-American alcoholismis another factor influencing the high incidence of this disease among thisethnic group. To compound the problem, they havefewer options available to them for publicly-sponsored treatment programs.This is because, for the most part, such programs have long waiting listsand often offer little incentive for African-Americans to remain incounseling. Westermeyer (1986, p. Rockville: NationalInstitute on Alcohol Abuse and Alcoholism, 19-36. Journal of Studies on Alcohol, 69(1), 8-2 . The areaof etiology, which demonstrated the most research, was found to concentrateon biological, cultural, and intrapsychic causations (King, 1986, pp. 227) continue thatsupport is given for the notion that alcoholism treatment agencies mustprovide either culture-specific, or culturally-focused services tosuccessfully treat African-American alcoholics. That is, African-Americans evidencing the above manifestationsmay decide to indulge in alcoholism or problem drinking as a copingmechanism; or their indulgence in alcoholism or problem drinking may leadto the manifestation of these variables. 712) notes that the presence of identity differencesbetween the treatment staff and alcoholic patients can significantlyinfluence access to care. Beyond these, feelings of socialisolation both prior to and during alcoholism treatment is at issue (Amaro,et al., 1987). Alcohol Health & Research World, 4 -51, 65 U.S. 491)notes: "The level of self-esteem in alcoholics is important because,assuming a poor self-concept facilitates drinking, self-esteem may have tobe raised before an adequate recovery from alcoholism can be made."Further, Beckman (1988) reports that the self-esteem of both femalealcoholics and problem drinkers tend to be lower than that of their malecounterparts and, indeed, may in part be the impetus for their decisions toconsume alcohol. (1983). In addition to the paucity of literature on African-Americanalcoholism, research outcomes evidence disparity. This often producesunfulfilled lives and the use of alcohol as a means to cope. Of those African-Americans who are insured, only 36percent are covered by Medicaid, while 67 percent have private insurance.For low-income African-American families, Medicaid is the major source ofcoverage (p. The results ofthe Amaro, et al. Maypole, M., & Anderson, J. King (1986, p. 495) found that the follow-upscores taken one year following initial testing were greater for women, at4.19 + 1.74, versus men, at 3.94 + 1.82. Furtherresearch, however, failed to confirm their findings. 2 + 3.62 (p. The response to the problem of alcoholism is a function of the conception of the problem and the values, prevailing beliefs, and world views of the respondent. 496)discovered that female alcoholics having low self-esteem scored -.448 forsocial isolation; -.5 for alienation; -.529 for neuroticism; -.175 forlocus of control; and -.498 for anxiety. On the Rosenberg Self-Esteem Scale, alcoholics had amean score of 2.83 for self-esteem versus that of 4.8 for their "normal"counterparts (Beckman, 1978, p. (1987) found that African-American clients had anaverage of two more children under age 18 than did white clients. A study of Aborigine alcoholicsfound that these clients returned for treatment at a considerably lowerrate than those of other Australian alcoholics when White professionalsprovided services. This may well be due in part to issues offamiliarity, proximity, communication, and acceptance. . Staff. Alcohol Health & Research World, 7 9-717.----------------------- 12 Westermeyer, J. Alcoholism and services forethnic populations. The issue of relapse, as per King (1986), can be decreased forAfrican-Americans, given the fulfillment of the above-noted variables.Further, satisfaction with therapeutic outcomes can be enhanced, withincreases in self-esteem evidenced (p. Consideration must be given to racism, poverty, unequal access to health care, cultural barriers, social factors, and psychological issues.Given the above-noted variables and the probability of bidirectionalcausality for alcoholism among African-Americans, service strategy mustintegrate cultural sensitivity with the sound practice of social work. Alcoholism and Blacks. Alcoholism and substance abuse. Gorowitz, et al. King discovered similar issuesin his 1985 review of the literature on African-American alcoholism andproblem drinking. Amaro, etal., (1987, p. Women and alcohol. Westermeyer (1986, p. Bailey, M.P. The issue of adequate education is as well of concern for African-American alcoholics. Blume, S.B. CenterCity, MN: Hazelden. 13)discovered in their 1985 study that African-Americans had an overall higherrate of alcoholism, with the members of this ethnic group constituting 2 per 1, , versus their White counterparts, at five per 1, . Beckman (1978, p. This, however, is the case for all Alcoholics. 71 -711) notes: "Regular employment,skilled or white-collar occupations, and economic resources have generallybeen associated with greater improvement following treatment." The age distribution for African-American alcoholics diverges fromthat of their White counterparts. This socialization isreinforced by means of significant-other modeling and teaching and includesgroups such as teachers, the media, the arts, and government. First, social services for African-American alcoholics must bedesigned so that service availability is provided in those areas in whichthis ethnic group resides, or in close proximity, to facilitate physicalaccessibility. (Bailey, 1986, p. Incidenceof Black alcoholism. A further indicatorof how identity differences may positively impact therapeutic outcome isthat of to what extent treatment staff perceive of African-Americansclients as similar. 8, 199 , p. Thomas. Further, there is acorrelation between self-esteem and the possible presence of adversevariables affecting the therapeutic process (i.e., locus of control,anxiety, alienation, and social desirability). Springfield:Charles C. (1988, p. 14) concluded thatthe absence of family support and splintered families (separated ordivorced) may also be relevant factors contributing to the early incidenceof African-American alcoholism. Thus, the notion of "differentness" may be affected bythe racial/ethnic composition of the staff as opposed to those of theclients. Gross, et al. Bratter, & G.G.Forrest (Eds.). (1983). Althoughthese amounts are not significantly different, it must be noted that thesocial isolation of African-Americans will continue past their completionof the treatment program, whereas Whites will most probably receive less(King, 1986). Thehighest incidence of alcoholism among this ethnic group was found to be inthe 35-44 age group. King, L.W. 1 ). Harper, F.D. (1986). The relative importance of thesevariables, and the manner in which they interact are as well issues needingaddress in the literature. AlcoholWorld Health & Research, 11(1), 5-18. (1986). 11) found intheir 1985 study that the median age of nonWhite men and women was 38years, versus those of 46 and 44 years for their White counterparts. 71 ) reports that ". References Amaro, H., Beckman, L., & Mays, V.M. (199 , January). . Beckman, L.J. Journal of Studieson Alcohol, 54(5), 9-14. These include the problemof low self-esteem, alienation from the society at large, their typicallyhaving low annual incomes, the lack of adequate insurance coverage, womenoften being heads of households, inadequate education, cultural and familybeliefs, and religious beliefs (U.S. For the most part, either case reduces the utilization ofhealth care services; and often leads to procurement of health care from avariety of providers (U.S. Washington,DC: U.S. Black alcoholism: An overview. In support of this,Westermeyer (1986, p. Rockville: National Institute onAlcohol Abuse and Alcoholism, 37-7 . In T.E. (1986). Alcoholism Treatment and Black Americans. The areas of incidence and prevalence; socioeconomicanalysis; characteristics, practices and patterns relative to African-American alcohol consumption were found to be particularly void of recentresearch on the parts of independent or government investigators. Further, the self-esteem ofalcoholic women tends at times to be less than that of their femalecounterparts who are receiving treatment for other psychiatric or emotionaldisorders. Department of Health and HumanServices, Vol. (1987) study revealed that a significant number ofAfrican-American clients failed to have access to treatment that comparedto that of their White counterparts. Bailey, et al., (1986,p. For example, self-esteem is clearly an important considerationin the individual's choice to consume alcohol. 11) suggest subsequent totheir 1986 study that African-Americans may begin drinking at earlier agesin response to the problems associated with late adolescence and earlyadulthood. Watts, T.D., Wright, R. Journal of Studies onAlcohol, 48(3), 22 -228. (1985). (1988, January). Department ofHealth and Human Services, Volume 8, 199 , p. Further, African-Americans lose their jobs to business restructuring and technologicalinnovations at a more rapid rate than that of their White counterparts.These factors contribute to the low annual income earned by the majority ofAfrican-Americans. African-American clients were found to have higher scoreson assessment of behavioral impairment and ounces of alcohol consumed on adaily basis. 41-49). 223). The rate of alcoholism among African-American women, that of theirmale counterparts, lacks consensus among numerous researchers, educators,and helping-profession practitioners. Westermeyer (1986, p. 494). (1982). Beckman (1988, p. There are several variables which negatively impact on the treatmentof African-American alcoholics/problem drinkers. 71). Department of Health and Human Services. In fact, 199 Census Bureau data revealed that 33percent of all African-Americans live below the national poverty level of$9,862 (U.S. Inaddition to these, many African-American females live near the povertylevel and often cannot afford costs such as babysitting fees andtransportation fees, so that they may be away from their children to attendtherapy. Of note is that 17.8 percent of African-Americans lackinsurance, with the inability to pay for it constituting the major reasonfor noncoverage. (1986, March). Self-esteem of alcoholics.Journal of Studies on Alcohol, 39(1-4), 491-498. 51) notes: The central issue is the nature of intervention into the problem of alcoholism, that is treatment strategies, prevention measures, and related actions. Viamontes and Powell (Bailey et al., 1986, p. Further, the 199 Census Bureau data also revealed that in excess of56.2 percent of all African-American households are headed by women; and7 .7 percent of them live below the poverty level (U.S. (1987). New York: Free Press. Department of Health and Human Services, Volume 8, 199 , p.1 ). Alcoholism treatment and Black Americans: Areview. Of these, only 11 specificallyaddressed the African-American population. Bell, P., & Evans, J. NewYork: MacMillan. blackalcoholics had less average education than white alcoholics in one sample." Although not all African-American alcoholics and problem drinkersexperience inadequate education, this is clearly a factor which canadversely affect the effectiveness of treatment for alcoholism. 1 9). Alcoholism treatment and Black Americans: Areview and analysis. The absence of insurance, or the presence of limited insurancecoverage, tends to adversely affect treatment procurement by African-Americans. A comparison of Blackand White women entering alcoholism treatment. These, in turn, tend toadversely affect the life choices of African-Americans, often resulting inpoor self-concepts, feelings of hopelessness and powerlessness, and ofbeing "less" than their White counterparts. 71 ) notes that African-Americans tendto fall in the unskilled occupations at approximately 5 -75 percent, whichis far higher than that of their White counterparts. Gross, R., Monczyski, L., & Widener, L. 226) report: "Feelings of social isolation vis-а-vis thelarger society are relevant to treatment especially if the client perceivesthe treatment program to be a part of the dominant culture rather than partof her own ethnic community." Amaro, et al., (1987, p. Counseling the Black client. Beckman (1988, p. Admissiontrends among Black alcoholics versus White alcoholics. Reportof the Secretary's Task Force on Black & Minority Health, 8. (1988, January-April). Second, fee schedules must be constructed to allow forvarying degrees of service eligibility, to provide for services to thoseAfrican-Americans who cannot afford to pay "regular" fees. Cahalan and Roomfound in their 1985 study that the difference between African-American andWhite heavy drinkers is negligible (Bailey, et al., 1986, p. 712). Printing Office. The self-esteem of women, thus,had increased by 1.29, versus that of .67 for men. Parallel to this is that they tend to have very limitedfinancial resources, which typically leads to decreased options in theselection of treatment facilities and access to more personalized services. Special Population Issues. Alcoholism: Studies regarding Black Americans1977-1985. For example, African-American alcoholicsconsistently use treatment facilities employing same-ethnic professionalsmore than do White alcoholics. The number of attempts to assessAfrican-American alcoholism have only recently grown, not all of which havedemonstrated sound validity and reliability (Harper, 1986; King, 1986).Harper noted in his 1986 analysis of the literature that only 89 scientificarticles out of 16, published over a 3 -year period through 1984discussed alcoholism and African-Americans. Thus, there are numerous psychosocialfactors in addition to prevailing norms and attitudes that impact African-American alcoholism. Further, because nearly 57 percent of African-American households areheaded by females, there is often lacking a sound family support system,the presence of which can have positive effects on therapeutic outcome. Department of Health and Human Services, Volume8, 199 , p. Incontrast, Zax, et al., (Bailey et al., 1986, p. Given the receipt of effective therapy, the self-esteem ofrecovering alcoholic women tends to increase at a higher rate than that oftheir male counterparts. While African-American clients scored 28.25 + 5.32 for socialisolation, their White counterparts rated 25. 51). (1985/1986, Winter). Westermeyer (1986) reports that the typical societalreliance on ethnic groupings to differentiate people and group them intocategories can serve to facilitate adverse, ingrained cultural beliefs.African-Americans are typically socialized to believe that they arepermanently assigned to the "out group" and, consequently will never attainappreciable membership in the greater society. As an instance, consider that "While White alcoholicsin Georgia were often advised to go for alcoholism treatment, Blackalcoholics had to make a clear and definite request to obtain suchassistance" (Westermeyer, 1986, p. Black alcoholism. 626) supports this, noting "Provisionfor adequate childcare will often be necessary before effective treatment." Third, the staff of said facilities must be ethnically/culturallydiverse, so that African-Americans can feel at ease and, resultantly, bemore open and honest in their communications. (1986, Fall). 1 9). Prevention of alcohol abuse among BlackAmericans. Fourth, the counseling style of those professionals providingservices to African-Americans must be such that a thorough knowledge oftypical ethnic group personality characteristics and societal variables areevidenced. Further,they tended to be far less financially able to afford babysitting fees.Blume (Bratter & Forrest, 1985, p. Harper, F.D. The literature on this topic revealed that the levels ofself-esteem were differentiated between those patients who were intreatment and those who were considered "normal." In fact, the self-esteemof those individuals considered "normal" tended to be much higher than thatof their counterparts who were in treatment for any type of psychiatric oremotional disorder. Suchsocialization is often deeply ingrained and injurious by means of thesystematic racism and discrimination that ensue. (1986, p. In addition to these, there are the problems oferratic treatment attendance patterns, the lack of a sufficient number ofsame-ethnic therapists, overrepresentation of other-ethnic male therapistsfor female clients, and a blatant lack of family support for thetherapeutic process (Maypole & Anderson, 1986). Rather,a number of the above variables may indeed be involved in bidirectionalcausality. 14). Subsequent to their 1976 survey of alcoholics in a variety ofMonroe County agencies, Zax, et al. There are numerous demographic variables which markedly differentiateAfrican-American alcoholics and problem drinkers from their Whitecounterparts. (1986/1987, Winter). 12) note "Attempts to systematically estimate the prevalence ofalcoholism or problem drinking among Blacks have been few and ofquestionable validity and reliability." Bailey et al., (1986, p. Amaro, et al. 14) discovered in their1984 study that 479 African-Americans out of 1 , were alcoholics orproblem drinkers. Gorowitz, M, Gross, R., & Widener, L. 14)discovered in their 1984 study that African-American women manifest ahigher rate of heavy drinkers over their White counterparts. Rockville: National Institute on Alcohol Abuse and Alcoholism, 71-83. 712) indicated that Native Americansincreased attendance at a variety of treatment centers when the staffmembers included a greater number of indigenous ethnic people. 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