Studies suggest that African Americans experience mental health concerns at the same rate as other Americans (Constantine, Myers, & Kindaichi, 2004). However, this population tends to underutilize available counseling services (Buser, 2009). Several studies have examined treatment utilization patterns and the causes for poor treatment adherence among this population (Jackson et al., 2007; Sussman, 2004).Authors have identified a number of potential barriers to successful treatment, including cultural mistrust (Whaley, 2001), stigma regarding mental illness, racism within the therapeutic exchange (Parham, 2002), and treatment modalities failing to address the cultural values and worldview of the client (Duran, Firehammer, & Gonzalez, 2008; Myers et al., 2005).
In part, because of the aforementioned barriers, African Americans often rely on informal networks of support in lieu of seeking counseling (Harley & Dillard, 2005; Parham, 2002). These networks typically include family and community resources, religious leaders, and indigenous healers (Yeh, Hunter, Madan-Bahel, Chiang, & Arora, 2004). In fact, African Americans are more likely to seek religious or spiritual experiences rather than admit to mental health concerns (Harley & Dillard, 2005). Spiritual and mental health concerns are often viewed as interconnected; therefore, religious institutions have an extensive history of providing both spiritual guidance and counseling services (Harley & Dillard, 2005). Within the African American community, indigenous African spiritual systems also have a long history of providing mental health services (Clarke, 2004). In fact, African Americans may rely on indigenous African spirituality as an alternative to Western forms of counseling (Boyd-Franklin, 2003). Although the scholarly literature has explored the therapeutic use of religion, little attention has been given to African-based spiritual systems used by African Americans as a mental health intervention (Boyd-Franklin, 2003; Constantine et al., 2004).
To assist counselors in increasing their level of cultural competency, this article explores historical factors prompting African Americans to choose African-based spiritual systems when addressing mental health concerns. Specifically, an overview of Yoruba-based Ifa is presented. This article places specific focus on Ifa because it is the largest indigenous African spiritual system practiced outside of its country of origin, Southwestern Nigeria (K. Abimbola, 2006; Falola & Genova, 2005). Ifa and its diasporic manifestations are currently followed by an estimated 100 million people worldwide (K. Abimbola, 2006). Diasporic manifestations of Ifa include Candomble in Brazil, Santeria in Puerto Rico, Lucumi in Cuba, Shango in Trinidad, and Yoruba within the United States (K. Abimbola, 2006; Falola & Childs, 2004). Scholars additionally note the increasing popularity of Ifa among African Americans as a healing modality (Boyd-Franklin, 2003; Clarke, 2004; Falola & Genova, 2004).
Finally, the conceptual, diagnostic, and treatment practices of Ifa are reviewed. Understanding this information will result in counselors gaining a broader knowledge base from which to work with African American Ifa adherents. This will enable clinicians to provide intervention strategies consistent with the client's beliefs regarding the etiology and treatment of mental health concerns. Providing culturally congruent interventions can result in improved treatment adherence among this population.
* Factors Influencing Selection of Indigenous African Spirituality as a Healing Modality
Sussman (2004) suggested that historical, social, and cultural variables influence the culturally constructed health care
systems developed by members of a particular society. These cultural healing systems include collectively held knowledge and beliefs regarding the cause, manifestation, and mitigation of mental health concerns among members of that group. Scholars posit that many Western intervention strategies fail to consider historical factors or the worldview of the client (Duran et al., 2008; Sussman, 2004). This approach toward care can result in the therapist misinterpreting a client's low treatment adherence as resistance rather than a culturally constructed means of managing and healing mental health concerns. However, within Western counseling, there is a growing trend toward the delivery of culturally competent counseling services (Constantine et al., 2004; Myers et al., 2005). This approach includes an examination of historical, social, and cultural variables influencing the client's worldview and treatment utilization patterns. The following example outlines the ways in which historical, social, and cultural variables influenced the use of Ifa as a mental health intervention among African American clients.
* Historical Interactions Within the American Mental Health Care System
Historically, within the mental health field, African Americans have been misdiagnosed and improperly treated for psychological concerns (Harley & Dillard, 2005; Parham, 2002). Studies suggest that African Americans are disproportionately diagnosed with psychotic disorders (Neighbors, Trierweiler, …