Cultural Adaption Interventions: Appraising a Mainstay of not a Challenge to the Whitenizing Homogenization of Mental Health Establishmentarianism: From the Pigeonhole to the Reconstructionist Horizon.

AuthorAzibo, Daudi Ajani ya
PositionViewpoint essay

The process of mental liberation [for African descent persons (ADP)] must proceed with care.... The desire for change [in mental health], I believe, is there, but the willingness to move toward change is stifled by the insidiousness of our Western indoctrination Cheryl Grills (2004b, 243) [About] the quest from social acceptance to social power.... First, it became clear to [ADP] that integration or assimilation does not necessarily signify equality because integration or assimilation also accompanies enslavement, subordination, colonialism, oppression, and caste. Hence, liberation from caste, subordination, oppression, and colonialism can be achieved through independence (or nationalism) from assimilating or integrating forces, groups, nations and agendas Ahati Toure (2010, 28) Backdrop

Multiculturalism is such a force in contemporary Eurasian-dominated psychology that the APA mandates teaching it for cultural competence purposes (American Psychological, 2011). It would be quite paradoxical if this sort of development actually represents a new racism emanating within the profession's Eurasian orthodoxy (Pon, 2009). Nevertheless, there would seem to be a conflict, perhaps even a war, within clinical psychology between the movements for cultural competence and multiculturalism on one hand versus evidence-based and empirically supported practices on the other (Gone, 2015). It has been ongoing (Elliot, 1998) and it reaches all the psy-professions. The latter movements (used interchangeably herein) are today dug in and dominating mental health establishmentarianism (MHE). This entrenchment is unfortunate as clinical practice based in empirical evidence that predominates MHE seems to be substantially, if not overall, harmful and regressive for non-Eurasians. Although this assertion is counterintuitive, the fact of the contestation referred to suggests in and of itself this is the case. When undressed below as elsewhere (Azibo, 2016a) it shows how empirically supported practices as conducted in Eurasian-based psychology inherently eradicate and preclude most elements of culture-focusing. Truly, this is colonial and narrow.

As might be expected, with vigor, many psychopathologists have resisted the narrowing of practice wrought by the emerged dominance of MHE's evidence-based movements (D. Goodman, 2016). Bohart, O'Hara and Leitner (1998), for example, decried the disenfranchisement of humanistic and other treatments that have resulted.

Henry (1998) is prophetic suggesting that the evidence-based movement runs the risk of reducing the quality of training and narrowing clinical treatment options, and gives even greater power to third-party payers as de facto untrained supervisors. Furthermore, Henry concludes that [this]... paradigm may disseminate findings that lead to little advance in knowledge, and may actually discourage empirical research in some areas. (126).

Quintana and Atkinson (2002) pointed to the areas of (a) problem etiology and (b) the impact of minority status and cultural variables as these affect counselor, client, and relationship characteristics as likely to suffer from the evidence-based movement's focusing on intervention research. All this has come to pass despite that "there are science-based forms of practice outside of the EST [empirically supported treatments] paradigm" (Bohart, 2000, 488).

Interestingly enough, dissatisfaction--some empirically based--with the EST paradigm's dominance vis-a-vis concerns of culture appears to be surfacing more and more in recent literature (Hayes, et al., 2016; Imel, et al., 2011; Owen, et al., 2012). However, MHE appears to proceed apace with its EST paradigm firmly entrenched barely acknowledging opposing or cautioning developments beyond lip service. Ironically, this sort of ignoring (or politely waiting out the complainers) belies MHE's EST paradigm as rooted in an evidentiary base as it begets a substantial amount of dubious results. For example, the literature review by Harder, et al (2012), regarding Aboriginals in Canada, points out not one study that utilized "indigenous methodologies" or treatment approaches, but only typical Western ones. The fundamental problem here should not be lost sight of: so much consuetudinary psychological work is being done on non-Whites/non-Eurasians ignoring their voices, the voices of the indigenous or racially and culturally other-than-Eurasian, that the empirical evidence catalogued may be meaningless category errors and transubstantiation thereby rendering said "evidence" akin to a paradigm without a phenomenon. Whether this obtains a great deal or a little bit, to that extent Emperor EST is peeped as having no clothes (or only tattered and eyehole clothing at best). Edward Sampson (1993) must cease being ignored or paid lip service by MHE as it is serious that[t]o have voice when one is required to speak in the forms allowed by the dominant discourse [or to be interpreted therefrom] is still not to have voice, that is, not to have self-determining self-representation. It is merely to speak [or be interpreted] as the dominant discourse permits, which means either to speak [or be interpreted] as one has been constructed by that discourse or to speak [be interpreted] through its gaze, perspective, and standpoint. (1227)

Fundamentally, precluding that state of affairs is what the culture-focusing, cultural competence, multiculturalism versus EST contestation in Eurasian-based psychology is supposed to be about when conducted at its best.

Still, each side of the contestation is inadequately informed by African-centered epistemological and historical perspective. This adds a layering for attention particularly regarding (a) pedagogical ramifications for treatment and training and (b) practical implications for intervention. Contributing to the rectification of this is the intended purpose of this article. Essential to this may be some background in nascent centered African psychology (meaning theory, research and practice using traditional African culture-based conceptualization of mental phenomena).

Indeed, there has been foresight about "signs... that psychology cannot continue to ignore these issues.... The message of African-[centered] theorists... is vital to the future of psychology as a whole" (Schultz, 2003, 60). In short, centered African psychological theorization began/begins with the construction approach (Azibo, 1996a).

The Constructive/Constructionist Approach to Psychological Inquiry for Backdrop

The epigraphs help with revealing that ahistorical participation in MHE's agenda for psychopathology by psychological workers who are ADP--which may be likened to their professional assimilation or integration into Eurasian-based psychology--is a limiting activity. This revelation may help broaden the gestalt of established practitioners. It may especially help faculty trainers and supervisors in better orienting students of African descent to their special location in the profession and the special truths the profession holds for them. One special truth is that MHE's role may actually be harmfully anti-ADP in that it conflicts with [c]entered African psychology [which] unabashedly by definition situates itself in the motivation or nia (purpose) to transform and maintain ADP culturally as Africans in perpetuity.... Therapy is directed to this end.... In so doing, the long ago call to "set afoot a new man [sic]" (Fanon, 1963, p. 316) is being answered at last. (Azibo, 2015e, 8).

MHE's agenda seems not geared to set afoot anew and aright ADP, leastways not in accordance with centered African personality theory (Azibo, 2015a, 2018). To bring about that noble task requires first amelioration of holistic (meaning both general and race-related) mental dysfunction in ADP and an undergirding of their psychological liberation away from assimilating or integrating forces, groups, nations and agendas. The adumbration here is part and parcel of the American lodestar of pluralism--which itself is militated against by MHE (Azibo, 2011). Psychological liberation for purposes pertaining to the re-birth of an empowered (Wilson, 1998) African civilization a la Williams (1993) has been asserted as the primary desideratum of contemporary African-centered psychology and personality (Azibo, 2014, 2015a, 2018; Azibo, Robinson-Kyles & Johnson, 2013; Grills, 2004a; Jamison, 2014). It would follow that an important way to contribute to ADP's psychological liberation requires that we seek out, respect, and learn from [African ancestral] knowledge. [Centered] African psychology holds promise in this regard. Azibo (1992) instructs us to orient (recognize and employ the African's own authentic experience as the base for psychological inquiry) and locate what we do in... the African cultural deep structure to provide patterns for interpreting the reality of authentic African experience). To properly orient and locate we must [a] more assertively consult... [ancestral African] wisdom.... from an African perspective and [b] develop appropriate applications to contemporary, contextually-based African... realities. (Grills, 2004b, 243)

It may need pointing out that these thoughts of Grills are relevant for psychological workers who are non-African descent in their relationship with ADP even though ethnocentrism and domination accompanying current Eurasian civilization may blind many to anti-oppression practice. Grills points to a two-step process--which may be added to existing Eurasian-based anti-oppression liberatory orientations like Larson (2008) and Morley (2003)--of consulting African deep thought about the nature of African human nature and then applying it in "a system of knowledge (philosophy, definitions, concepts, models, procedures and practice) concerning the nature of the social universe from the perspective of African Cosmology." This quotation is actually an excellent definition of centered African psychology...

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