Re-Building Strength Among Black Women: Implications of a Evidenced Based, Culturally Congruent Group Intervention

Purpose: According to large epidemiological surveys rates of depressive disorders among Black women are lower or equivalent to the rates among White women (Blazer, Kessler, McGonagle, & Swartz, 1994; Jackson, Torres, Caldwell, Neighbors, Neese, Taylor, Trierweiler, Williams, 2004; Kessler, Berglund, Demler, Jin & Walters, 2005). Despite the comparable rates of depression among Black and White women, research on prevention and treatment for women with depression has primarily focused on White women and the exclusion of ethnic minorities in depression outcome studies are extensively documented (Brockting, Spinhoven, Koeter, Wouters, Visser, Schene, et al., 2006; Miranda & Cooper, 2004; Reay, Fisher, Robertson, Adams, & Owen, 2006). This limitation of treatment outcome studies is problematic, since Black women are increasingly entering public sector services to alleviate problems associated with depressive symptoms (Cooper-Patrick, Crum, Powe, Pratt, & Ford 1999). These findings underscore the importance of developing, implementing and evaluating of culturally congruent interventions for depression among Black women. The author presents data from an efficacy study entitled, “Claiming Your Connections” (CYC) that evaluated a culturally congruent group treatment model, aimed at reducing depression symptoms and enhancing psychosocial competence among Black women.

Methods: Using a systematic random sampling method, the study evaluated the impact of the CYC group intervention program to a waitlist control group in a sample of 58 Black women who self identified as having “difficulty (emotional) managing task of daily life”. Participants were recruited through a: women-only shelter program, a mixed-gender, residential drug treatment program and a community based health center. Primary inclusion criteria included women 18 yrs or older who self identified as being, “having difficulty managing tasks of daily life”, and reported no current involvement in mental health services. Exclusion criteria included any diagnosis of psychosis, suicidal or homicidal behavior. The CYC intervention consisted of 10 weekly, 90 minute sessions. The CYC intervention is an empirically validated (Jones, 2004; 2006) culturally congruent manulized protocol for stress symptom alleviation, while utilizing a psychosocial competence framework to enhance women's sense of mastery over their life outcomes and to increase their coping capacities. Data analyses included descriptive statistics, chi-square/independent two sample t-test analysis were conducted on demographic variables to estimate differences and multivariate repeated measures analysis of variance (MANOVA) was used to test changes over the two time periods for the outcome variables.

Results: At pretreatment both groups indicated moderate levels of depressive symptoms, perceived stress, and psychosocial competence. At post intervention, the CYC groups reported a significant reduction in depressive symptoms and perceived stress compared to the wait-list control groups. F-values representing the outcome variables were found to be significant at the .01 level for the main effects of both time and condition for the variables of depressive symptoms and perceived stress.

Implications: The data provide promising findings for the CYC group intervention program and its efficacy with Black women who report having difficulty managing stressors of daily life. Implications and directions for the development of future culturally relevant practice interventions with this population are presented.