Researchers, scholars and counseling practitioners note the differences in help-seeking behaviors among racial and ethnic minority clients. With African Americans in particular, researchers attribute some of these differences to African Americans’ preference for relying on their spiritual and religious communities (i.e., the Black Church) for support in dealing with mental health issues rather than seeking help from professional mental health counseling resources. However, less articulated in the literature are the rationales behind this preference. Because of the salience of spirituality and religion in the African-American community, it behooves counselors to increase their knowledge of the African-American religious experience. This article provides an overview of the history of the Black Church, its theological foundations, implications for culturally competent counseling and recommendations for counselors in practice.
Keywords: African American, religion, spirituality, Black Church, mental health counseling
Kuczewski (2007) asserted that helping professionals often are charged to care for “vulnerable persons facing difficult situations and tragic choices” (p. 9). Often, within the counseling context, client spirituality is an important part of the healing process. There is substantial evidence that one’s religious life is a critical feature of the developmental process and can serve to improve one’s overall well-being (Cashwell & Young, 2011). Further, researchers have found positive benefits to incorporating spirituality and faith into one’s life, including improved physical (Matthews et al., 1998) and psychological (Joubert, 2010) health. Therefore, counselors are expected to assess the impact of a client’s spirituality and religion on his or her mental health and overall well-being (Cashwell & Watts, 2010). Moreover, attending to the spiritual needs of clients is an essential part of developing culturally sensitive treatment plans and recommendations (Kuczewski, 2007).
Not unlike other racial groups, African-American families rely on spirituality as a source of support as they face various challenges. These challenges include both systemic oppressions (e.g., overt racism) and familial stressors (e.g., parenting). Given these life stressors, perhaps spirituality and religion offer some explanation as to why African Americans are better adjusted and more psychologically well than some experts expect and predict (Bell-Tolliver & Wilkerson, 2011).
Nearly 80% of African Americans identify religion as important compared to only 50% of the general population (Pew Research Center, 2009). Further, a majority of African Americans identify as Christian, and 50% of African Americans attend church services weekly. The majority of African Americans attend a predominantly African-American church (Pew Research Center, 2009). Many African Americans identify God as a core aspect of their coping, and rely on their religion and spirituality during difficult life transitions (Bell-Tolliver & Wilkerson, 2011; Whitley, 2012). Additionally, African Americans assert that attending worship services and Bible study, being involved in their churches, having devotion time, and listening to religious sermons and gospel music allow them to conceptualize their struggles within the larger struggle between good and evil, or God and the devil (Whitley, 2012).
Because of the salience of spirituality and religion in the experience of African Americans, it behooves professional counselors to increase their knowledge and awareness of the African-American religious experience, particularly as it relates to psychological health. Several researchers (Ayalon & Young, 2005; Woodward, 2011) have found that African Americans tend to seek professional counseling at a much lower rate than other racial and ethnic populations. Further, African Americans often choose their spiritual leaders and churches as resources for their mental health needs instead of professional counselors (Ayalon & Young, 2005). Thus, one area of the African-American religious experience that needs further attention from counselors is the Black Church. The Black Church is the term used in popular culture and scholarly literature to refer to the overall institution that encompasses individual, predominantly African-American Christian congregations (Lincoln & Mamiya, 1990).
In order to understand the Black Church and the people who worship therein, counselors must familiarize themselves with the historical context and theological underpinnings that frame the Black Church and likely influence individual parishioners’ help-seeking behaviors. The purpose of this article is to provide a brief overview of the history and development of the Black Church, built upon unique theological foundations. These elements of history and theology have important implications for counselors working with religious African-American clients.
History of the Black Church
Similar to African-American communities, the Black Church has experienced change, progression, challenges, struggle and resilience. Counselors must understand the historical role and relevance of the Black Church in African-American communities in order to better understand African-American mental health help-seeking behaviors. This section will provide an overview of the Black Church’s inception during slavery, its role in the Civil Rights Era and its relevance in the lives of many African Americans in the 21st century. This history will provide counselors with a context for understanding the Church’s salience in the lives of many of their religious African-American clients.
The Black Church and Slavery
During slavery, many plantation owners forbade more than five slaves to gather at a time without supervision by a White overseer. Although slaves possessed a desire for religious and spiritual expression, this rule complicated their ability to assemble for worship services and stifled their sense of community and opportunities for fellowship. Thus, in fear of repercussions for breaking these rules, slaves resorted to informal worship gatherings in secret locations (e.g., swamps and wooded areas; see Frazier, 1963; Lincoln, 1973). Eventually, during the mid-1700s, these informal gatherings became less secretive and more visible (Pinn, 2011), laying the foundation for the institution that would be become known as the Black Church. The churches became the epicenter of the slaves’ community and a place of education and fellowship that slaves lacked elsewhere on the plantation.
During the genesis of the Black Church, plantation owners feared that if slaves were able to read the Bible, their proclivity to defer hopes of freedom until after death would decrease, and a surge of strength and demand for emancipation would emerge. Slave masters feared that slaves would acquire a comprehensive knowledge of Scripture that would illuminate the flaws and Biblical inconsistencies of a despotic slave system. With a comprehensive knowledge of Scripture, slaves would have an increasingly difficult time reconciling a Biblically based system that would capture and enslave innocent people (Taylor, Thornton, & Chatters, 1987). As predicted, slaves became discontented with their situation and used the Church as a means to bring about change. As slaves’ Scriptural knowledge grew, so did their frustration with organized religion, particularly Christianity. Slaves viewed Christianity as another vehicle used by Whites to advance oppression (Lincoln & Mamiya, 1990).
Slave masters and their families treated slaves poorly even though they worshipped together in the same buildings. Instead of church being a sacred haven away from maltreatment, it was another opportunity for Whites to exert their power, which became overwhelming for many Blacks (Lincoln & Mamiya, 1990). Thus, slaves incepted their own churches out of a desire to have their own worship places on Southern plantations and escape discrimination on Sunday mornings (Lincoln, 1973). Richard Allen inaugurated the first Black church of the Methodist denomination in 1807 (Wilmore, 1998). The formation of the Black Methodist churches was considered a visceral response to the Methodist tradition of having segregated churches for Blacks and Whites. This departure of Blacks from the Methodist Church was one of the first major civil rights protests by African Americans (Lincoln & Mamiya, 1990). Subsequently, African Americans formed predominantly African-American congregations of Baptist, Presbyterian and Episcopal denominations (DuBois, 1903), setting the stage for the prominent emergence of the Black Church during the Civil Rights Era. Slaves felt that they could be themselves and their status as slaves did not subsume their identity in these churches. These services provided therapeutic relief and a departure from the pressures and brutality experienced on the plantation (Wilmore, 1998).
In essence, church services and religious and spiritual resources operated much like counseling sessions. Slaves found hope in the Scriptural promises of a future void of oppression. They looked forward to death as a transition from suffering on earth to a promise of reward and deliverance in Heaven (Johnston, 1954; Wilmore, 1998). Slaves especially could relate to the persecution and torment of Jesus Christ, the pivotal figure of Christianity. In fact, slaves even likened the crucifixion experienced by Christ to the popularized practice of lynching Black men (Pinn, 2010; Terrell, 1998). Terrell (1998) further elaborated that the connection between Jesus and slaves also was related to the Bible story of Judas betraying Jesus for economic compensation. Slaves knew that White plantation owners betrayed, captured and brought them to America for others’ economic gain (Pinn, 2011; Terrell, 1998).
Although slaves faced horrendous conditions on plantations, counseling services obviously were not available as a support and therapeutic release. During this time, the Church was the primary resource for support and change during life challenges. It is likely that this proclivity to seek support from the Church began during slavery and continues today. This historical precedent could help explain why African Americans are less likely than many other racial/ethnic groups to seek support from professional counselors (Ayalon & Young, 2005).
The Black Church and Civil Rights
During the 1950s and 1960s, the Black Church became increasingly more autonomous as it began expanding doctrinal beliefs, electing leaders and even creating seminary institutions to educate its leaders (Lincoln, 1973). Further, the Black Church offered a platform for activists to promote messages of equal rights for African Americans (Chandler, 2010). The Black Church worked at both the macro and micro levels of society. For example, on the macro level, large institutions such as the NAACP garnered support (e.g., financial, emotional) from the Black Church (Chandler, 2010). At a more micro level, individuals with difficulty fulfilling financial obligations received economic assistance. The Black Church’s growing financial independence initiated the self-help doctrine, as African Americans could not rely on support from outside sources. African Americans learned that in order to survive they had to support themselves financially, mentally, emotionally and socially (Littlefield, 2005). It is possible that African Americans may still maintain this perspective, and therefore may be less likely to seek support from resources such as professional counselors.
Particularly during the Civil Rights Era, the Black Church was a place that Blacks could experience prestige, rank and authority otherwise denied them by outside institutions, which were typically dominated by the majority culture (Douglas & Hopson, 2001). Thus, many African Americans may be distrustful of the counseling relationship, as it may reflect the larger dominant culture from which they have experienced exclusion and oppression (Sue & Sue, 2013).
The Black Church in the 21st Century
While the Black Church of past decades struggled with achieving equal rights in the community, the contemporary Black Church faces its own set of unique challenges. These challenges are related to health (e.g., HIV/AIDS) and social issues (e.g., welfare reform, disproportionately high unemployment rates for African Americans; Billingsley & Caldwell, 1994). Nonetheless, African Americans have certainly made considerable strides in advancement compared to previous decades, notably in the areas of education. Many argue that these strides should be attributed, at least in large part, to the efforts of the Black Church (Byrd, 2001). These strides are particularly important as the African-American community faces issues such as disproportionate rates of physical illness, financial strains, anxiety, depression and familial concerns (U.S. Department of Health and Human Services, 2001; 2011). Although these challenges may seem daunting for African-American communities and the Black Church in particular, scholars encourage the Black Church to draw on the strength that brought it through turbulent times such as slavery and the Civil Rights Era (Billingsley & Caldwell, 1994). Given the historical involvement of the Black Church in all aspects of the individual lives of African Americans, it is understandable that many African Americans may view their local churches as a viable alternative resource to professional counselors. Therefore, counselors should involve themselves in African-American communities and familiarize themselves with local churches. Counselors have a unique opportunity to partner with Black churches in their communities to build trust, decrease stigma around help seeking, assist in combating concerns facing many African Americans and learning about the impact of Black Church theology.
Black Church Theology
Just as it is important to understand the historical context of the Black Church, it is imperative to understand the Black Church’s foundational belief systems in order to thoroughly understand its roles and functions. Theology unites the collective Black Church, but also differentiates between local congregations. Often, individual churches and denominations vary in theological principles, and therefore differ in how they execute beliefs about their purpose, roles and responsibilities (Barber, 2011; Lincoln, 1974). Often, the Black Church is mistaken as a homogenous grouping of individual churches. However, theological differences make this a false pretense (Barber, 2011). These theological positions can serve as overarching guiding principles and influences for parishioners’ individual lives and their choices, including decisions about seeking help from professional counselors.
Although theological differences exist, most Black churches unite in the theological belief that during worship services their members experience a personal visitation from Jesus. Typically, this theological notion guides the way services are conducted. This visitation could be manifested through rituals and practices such as shouting, singing gospel songs and hymns, or speaking in tongues. To that end, Moore (2003) noted these behaviors as examples of the liberal and animated worship that often is indicative of the Black Church. Other practices that are common to the Black Church and reflective of its theology may befuddle those unfamiliar with the structure of the Black Church service. For example, members of the Black Church may be more likely to reference God and Jesus interchangeably in spiritual practices, such as prayer, which could be confusing to some outside observers (Johnson, 2010).
These complexities could confuse counselors not immersed in Black Church culture. Moreover, many observers question the variations in theology and the often ambivalent character of an institution that can be so progressive on one hand, yet quite rooted in traditional theology on the other hand. This apparent ambiguity gives many observers pause (Douglas & Hopson, 2001). The religious theology that guides the Black Church can provide helpful insight for counselors interested in increasing their multicultural competence and understanding of African-American clients. Often, this theology can influence individual congregation members’ personal lives, including how they make choices regarding whether to seek professional counseling. The following section elaborates on various theologies and how they may manifest in African-American clients.
James Cone’s liberation theology is one of the most prevailing schools of thought in the Black Church (McBeth, 1981). According to liberation theology, African Americans took Christianity, traditionally perceived as a White man’s religion, and adapted it to the plights and triumphs of African Americans. Compared to other theologies, liberation theology is seen as a comprehensive theology because it considers how individuals view God and how they interact with one another. According to liberation theology, the Black Church offered oppressed Blacks a sense of freedom rarely experienced in their day-to-day lives. The Black Church was a place where African Americans had the opportunity to gather and vent about their problems as a community. Additionally, the Black Church was a place where change could be created and enacted (McBeth, 1981). While other theologies focus on Caucasians as oppressors, churches whose members ascribe to liberation theology tend to focus less on the oppression and more on the freedom that is felt when congregation members experience fellowship with one another (Burrow, 1994). Because slaves viewed the master–slave relationship as the epitome of evil, African Americans placed a significant emphasis on forming and preserving healthy relationships (Burrow, 1994; Douglas & Hopson, 2001). Liberation theology values addressing people holistically, emphasizing the connection of the body and the mind (Burrow, 1994).
Alternate Society Theology
Frazier’s idea of the alternate society is somewhat similar to liberation theology, in that he proposed that the Black Church should operate as a sovereign society where African Americans would be able to fully express their authentic selves (see McBeth, 1981). Frazier founded this theology upon the belief that Caucasians did not understand African Americans, and therefore could not adequately meet their needs (Frazier, 1963). Frazier endorsed the idea that the Black Church would be a separate nation within the United States and would meet the needs of African-American communities in ways beyond just the spiritual. Optimally, the Black Church would be able to produce education centers, financial institutions, housing and a social outlet (Lincoln & Mamiya, 1990). Ironically, Frazier acknowledged that this alternate society would further inhibit Blacks from successfully acculturating in the majority culture in which they were expected to live and function (Frazier, 1963). It is likely that churches ascribing to this theology believe they will be able to meet both the psychological and spiritual needs of congregation members. In fact, in churches where this philosophy is predominant, it is possible that members who seek guidance from church leaders may be discouraged from seeking services such as professional counseling outside the Black Church.
Other-Worldly and This-Worldly Theology
Other-worldly churches are those whose members believe in deferring freedom and reward until after death. In other words, these churches’ members are more accepting of present pain and suffering since they believe they will experience relief posthumously in Heaven. Spiritual songs birthed to comfort, direct and relieve Black slaves became a critical part of other-worldly theology. These songs have served as a reminder that earthly suffering is temporary and an eternal promise of heavenly peace awaits upon death (Cashwell & Young, 2011). Also, pastors serve as an important mouthpiece for other-worldly theology. During slavery, preachers often delivered sermons reminding listeners of life after death, a life that contrasted with the current reality of enslavement. Today, although some of the challenges facing African Americans may be different, some pastors continue to uphold messages of enduring present suffering and awaiting the promises that accompany death (Wilmore, 1998). Attendees of other-worldly churches may be less likely to present in counseling, but when they do, it is critical for the counselor to understand that the client may be less oriented to solving his or her problem and more oriented to focusing on life after death. Failing to understand and embrace this perspective might lead some counselors to focus prematurely on problem-solving tasks that might damage the therapeutic relationship.
Conversely, this-worldly churches typically advocate explicitly for Blacks to experience earthly freedom and happiness. For example, whereas a member of an other-worldly church may be satisfied with receiving physical healing through death, a member of a this-worldly church may pursue other avenues to minimize pain and suffering and delay death as much as possible (Lincoln & Mamiya, 1990). These ideas about suffering also could manifest in one’s attitudes about psychological health and needs for counseling. Clients from this-worldly churches may possess a greater sense of urgency to seek counseling during times of psychological discomfort compared to clients from other-worldly churches, who may be less inclined to alleviate emotional distress.
Recommendations for Counselors
Sue and Sue (2013) challenged culturally competent counselors to appreciate and incorporate clients’ history, worldviews and life experiences into the counseling relationship. One critical dimension of those considerations is clients’ religious and spiritual backgrounds (Cashwell & Young, 2011). Specifically, for religious African-American clients, this process involves examining the intersection of at least two social identities (i.e., what it means to the client to be religious and what it means to be African American; Roccas & Brewer, 2002). One essential aspect of many African Americans’ identity is the Black Church and the expression of its various theological perspectives. Thus, it is important that counseling practitioners, counselor educators and clinical supervisors are aware of the nuances of the Black Church and African-American religion and spirituality. Additionally, counseling professionals should be aware of the theology of each individual client’s local church, which could influence communal beliefs about symptomology and counseling. Counselors should use this information to increase understanding and inform accurate diagnoses, as well as competent treatment plans and recommendations (Association for Spiritual, Ethical, and Religious Values in Counseling [ASERVC], 2009; Cashwell & Watts, 2010). To that end, counselors can incorporate the following strategies in recruiting and retaining African-American clients who identify as religious and as members of the Black Church.
African-American clients active in churches with particular theologies (e.g., alternate society theology and other-worldly theology) may be disinclined to seek counseling services outside the church. Congregants may receive messages that the church can take care of all of their concerns, including mental health issues. Moreover, many churches (particularly within the alternate society theological tradition) may offer programs (e.g., financial seminars to address income-related stress) that attend to many of the needs of church members. In these cases, members may not feel a need to go outside to professional counselors. These clients may not voluntarily seek services from professional counselors even when their presenting concerns may warrant intervention. Thus, it is important for counselors to contact local Black Church congregations to establish relationships, form trust and increase visibility. Rather than depending on African Americans to initiate communication with mental health professionals, counselors can volunteer outreach services and host programs at local churches in an effort to increase access to African Americans. Counselors are expected to operate as advocates and proponents of change for their clients (Sue & Sue, 2013); often the Black Church is a hub of social justice advocacy efforts within African-American communities (Lincoln & Mamiya, 1990). Traditionally, programs in the Black Church have provided clothing, substance abuse services, tutoring, mentoring and nonreligious education services (Tsitsos, 2003). Counselors can partner with the advocacy efforts of the Black Church to help church members in need. These needs range from issues within the family to more systemic issues that affect a large number of African Americans (e.g., unemployment, poverty, AIDS/HIV, incarceration, anxiety, depression). These efforts may increase church members’ comfort level with counseling and decrease stigma associated with seeking help.
Specifically, counselors can connect with local pastors, since pastors are very influential in the Black Church and African-American communities in general (Billingsley & Caldwell, 1994; Lincoln & Mamiya, 1990; Mattis et al., 2007; Roberts, 1994). Often, the pastoral role extends beyond spiritual responsibilities, as the majority of African Americans prefer to seek psychological help from their pastors rather than professional counselors (Ayalon & Young, 2005; Chatters et al., 2011). Pastors may be more likely to refer congregation members to trusted counselors who are visible in their community. Counselors likewise have the opportunity to learn more about the pastors’ approaches to responding to mental health needs in their congregations.
In addition, theology is important for counselors in formulating client conceptualizations and treatment recommendations. In particular, counselors should be aware of when the client’s beliefs about healing juxtapose with the professional’s knowledge of science (Kuczeweski, 2007), and where counselor biases might be imposed on the client. For example, it is important that counselors are cautious in labeling presenting concerns as problematic when working with a client from a church that focuses on liberation theology. Such clients may choose to focus less on the presenting concern and instead take a more strength-based, optimistic perspective. Clients who attend churches that emphasize liberation theology may be open to more holistic treatment recommendations and reluctant to rely on psychotropic medications to alleviate symptoms. Thus, counselors should be aware of this preference when referring clients to a psychiatrist and suggesting medication as a part of the treatment plan.
Counselors are encouraged to work from theoretical orientations that are sensitive and inclusive of clients’ religious and spiritual identities (ASERVC, 2009). Since theology is an important part of many religious African Americans’ identities, the counselor should be careful not to approach the counseling relationship from a theoretical orientation that contradicts the client’s theological orientation. The biopsychosocial-spiritual model (Cairns, 2011: Engel, 1977) is a culturally sensitive theoretical framework that allows for a client to be holistically assessed from a biological, psychological, social and spiritual perspective. With the addition of the spirituality component to the traditional biopsychosocial model, the religious coping strategies of many African-American clients have been considered, addressed and appreciated (Clark, Anderson, Clark, & Williams, 1999). Further, the importance of addressing people holistically, emphasizing the connection of the body and the mind, is rooted in liberation theology (Burrow, 1994). In this regard, it appears that the spiritually founded liberation theology of the Church and the biopsychosocial-spiritual model may complement one another well. Leaders of the Black Church may not automatically articulate views using the language of the biopsychosocial-spiritual, but are likely to be able to do so using the language of liberation theology. Thus, it is incumbent upon counseling professionals to probe deeper into the intersections of Black Church theology and counseling models.
Counselors should educate themselves on current events and issues that may be affecting the African-American community in general (e.g., recent events in Ferguson, Missouri) and their clients in particular. Although many of these issues could be disheartening (e.g., disproportionate representation of African Americans in many vulnerable populations), counselors also should be aware of advancements made within the African-American community and work from a strength-based developmental approach that honors the uniqueness of the African-American community in general, and in particular, the Black Church. This perspective is vital, as many references to African Americans are negative, given their disproportionate representation in many vulnerable populations. It could be tempting for counselors to focus on the negative; however, focusing on the positive and acknowledging advancements could serve as a corrective experience for many African Americans.
Because of the centrality of relationships within the Black community, counselors should consider social supports, such as church members, who could serve as great resources for clients during and after the counseling process. For example, counselors should be open to consulting with spiritual advisors and referring clients to their pastors if deemed appropriate. Historically, church members have served as an extended family for many African Americans (Ellison, Musick, & Henderson, 2008; Lincoln & Mamiya, 1990). Therefore, fellow church members also could be included in the counseling process, both within and outside counseling sessions as resources and support systems.
Counselors should invite clients to talk about recent worship services and spiritual experiences in counseling sessions. It is important that this encouragement is made from a curious stance that is noncritical and nonjudgmental. This invitation not only allows the client to integrate his or her spirituality into counseling, but also allows the counselor to learn more about the client’s religious background and preferences, as well as his or her specific church culture.
A counselor also can incorporate creative interventions that integrate a client’s religious and spiritual influences. For example, the counselor could invite the client to compile a list of his or her favorite gospel songs as a musical chronology and emerging life song. This process allows client and counselor to extrapolate themes and values that are important to the client (Cashwell & Young, 2011; Duffey, 2005). Given the historical importance of spirituals, the client could write songs or use existing songs to help articulate presenting concerns to his or her counselor. Additionally, the counselor becomes privy to the client’s spiritual values and theological beliefs by listening to song lyrics. Similar interventions might include asking the client to create a list of favorite Biblical stories or specific scriptures. Additionally, the counselor can ask the client to construct a spirituality genogram, which can provide invaluable information about the role of the Church in the client’s family and its influence on their individual lives (Cashwell & Young, 2011).
Researchers, scholars and counseling practitioners have noted the differences in help-seeking behaviors among racial and ethnic minority clients. With African Americans in particular, researchers have attributed some of these differences to African Americans’ preference for seeking help from spiritual resources rather than professional counseling resources. When exploring the mental health help-seeking behaviors of African Americans, it is imperative to pay particularly close attention to the role of religion, the Black Church and theology in the counseling experiences of many African-American clients. Learning more about various theological traditions and working from a culture-centered framework can substantively increase the quality of counseling services.
Conflict of Interest and Funding Disclosure
The authors reported no conflict of
interest or funding contributions for
the development of this manuscript.
Association for Spiritual, Ethical, and Religious Values in Counseling. (2009). Competencies for addressing spiritual and religious issues in counseling. Alexandria, VA: Author.
Ayalon, L., & Young, M. A. (2005). Racial group differences in help-seeking behaviors. The Journal of Social Psychology, 145, 391–403. doi:10.3200/SOCP.145.4.391-404
Barber, K. H. (2011). “What happened to all the protests?”: Black megachurches’ responses to racism in a colorblind era. Journal of African American Studies, 15, 218–235. doi:10.1007/s12111-010-9154-x
Bell-Tolliver, L., & Wilkerson, P. (2011). The use of spirituality and kinship as contributors to successful therapy outcomes with African American families. Journal of Religion & Spirituality in Social Work: Social Thought, 30, 48–70. doi:10.1080/15426432.2011.542723
Billingsley, A., & Caldwell, C. H. (1994). The social relevance of the contemporary Black Church. National Journal of Sociology, 8, 1–23.
Burrow, R., Jr. (1994). James H. Cone and Black liberation theology. Jefferson, NC: MacFarland.
Byrd, A. D. (2001). Adult educational efforts of the American Black church, 1600–1900. Journal of Religious Thought, 44, 83–93.
Cairns, W. (2011). Science relocating spirituality into the bio-psycho-social. Palliative Medicine, 26, 187–188. doi:10.1177/0269216311433927
Cashwell, C. S., & Watts, R. E. (2010). The new ASERVIC competencies for addressing spiritual and religious issues in counseling. Counseling and Values, 55, 2–5. doi:10.1002/j.2161-007X.2010.tb00018.x
Cashwell, C. S., & Young, J. S. (Eds.). (2011). Integrating spirituality and religion into counseling: A guide to competent practice. Alexandria, VA: American Counseling Association.
Chandler, D. (2010). The underutilization of health services in the Black community. Journal of Black Studies, 40, 915–931. doi:10.1177/0021934708320723
Chatters, L. M., Mattis, J. S., Woodward, A. T., Taylor, R. J., Neighbors, H. W., & Grayman, N. A. (2011). Use of ministers for a serious personal problem among African Americans: Findings from the National Survey of American Life. American Journal of Orthopsychiatry, 81, 118–127. doi:10.1111/j.1939-0025.2010.01079.x
Clark, R., Anderson, N. B., Clark, V. R., & Williams, D. R. (1999). Racism as a stressor for African Americans: A biopsychosocial model. American Psychologist, 54, 805–816. doi:10.1037/0003-066X.54.10.805
Douglas, K. B., & Hopson, R. E. (2001). Understanding the black church: The dynamics of change. The Journal of Religious Thought, 56/57, 95–113.
DuBois, W. E. B. (Ed.). (1903). The negro church. Walnut Creek, CA: Altamira Press.
Duffey, T. (2005). A musical chronology and the emerging life song. Journal of Creativity in Mental Health, 1, 141–147. doi:10.1300/J456v01n01_09
Ellison, C. G., Musick, M. A., & Henderson, A. K. (2008). Balm in Gilead: Racism, religious involvement, and psychological distress among African-American adults. Journal for the Scientific Study of Religion, 47, 291–309. doi:10.1111/j.1468-5906.2008.00408.x
Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196, 129–136.
Frazier, E. F. (1963). The Negro church in America. New York, NY: Schocken Books.
Johnston, R. F. (1954). The development of negro religion. New York, NY: Philosophical Library.
Johnson, M. V. (2010). The tragic vision of African American religion. New York, NY: Palgrave MacMillan.
Joubert, N. (2010). How Christianity spirituality spurs mental health. In J. H. Ellens (Ed.), The healing power of spirituality: Vol. 3. Psychodynamics (pp. 238–266). Santa Barbara, CA: Praeger.
Kuczewski, M. G. (2007). Talking about spirituality in the clinical setting: Can being professional require being personal? The American Journal of Bioethics, 7, 4–11. doi:10.1080/15265160701399545
Lincoln, C. E. (1974). The Black Church since Frazier. Schocken Books: New York, NY.
Lincoln, C. E. (1973). Black consciousness and the Black Church in America. Missiology: An International Review, 1, 7–20. doi:10.1177/009182967300100203
Lincoln, C. E., & Mamiya, L. H. (1990). The Black Church in the African American experience. Durham, NC: Duke University Press.
Littlefield, M. B. (2005). The black church and community development and self-help: The next phase of social equality. The Western Journal of Black Studies, 29, 687–693.
Matthews, D. A., McCullough, M. E., Larson, D. B., Koenig, H. G., Swyers, J. P., & Milano, M. G. (1998). Religious commitment and health status: A review of the research and implications for family medicine. Archives of Family Medicine, 7, 118–124.
Mattis, J. S., Mitchell, N., Zapata, A., Grayman, N. A., Taylor, R. J., Chatters, L. M., & Neighbors, H. W. (2007). Use of ministerial support by African Americans: A focus group study. American Journal of Orthopsychiatry, 77, 249–258. doi:10.1037/0002-94184.108.40.206
McBeth, L. (1981). Images of the Black church in America. Baptist History and Heritage, 16(3), 19–28, 40.
Moore, P. J. (2003). The black church: A natural resource for bereavement support. Journal of Pastoral Counseling, 38, 47–57.
Pew Research Center. (2009, January). A religious portrait of African-Americans. Retrieved from http://www.pewforum.org/2009/01/30/a-religious-portrait-of-african-americans/
Pinn, A. B. (2010). Understanding & transforming the black church. Eugene, OR: Cascade Books.
Pinn, A. B. (2011). What is African American religion? Minneapolis, MN: Fortress Press.
Roberts, J. D. (1994). The prophethood of Black believers: An African American political theology for ministry. Louisville, KY: Westminster/Knox Press.
Roccas, S., & Brewer, M. B. (2002). Social identity complexity. Personality and Social Psychology Review, 6, 88–106. doi:10.1207/S15327957PSPR0602_01
Sue, D. W. & Sue, D. (2013). Counseling the culturally diverse: Theory and practice (6th ed.). Hoboken, NJ: Wiley & Sons.
Taylor, R. J., Thornton, M. C., & Chatters, L. M. (1987). Black Americans’ perceptions of the sociohistorical role of the church. Journal of Black Studies, 18, 123–138.
Terrell, J. M. (1998). Power in the blood? The cross in the African American experience. New York, NY: Orbis Books.
Tsitsos, W. (2003). Race differences in congregational social service activity. Journal for the Scientific Study of Religion, 42, 205–215. doi:10.1111/1468-5906.00173
U.S. Department of Health and Human Services. (2001). Mental health: Culture, race, and ethnicity—A supplement to mental health: A report of the surgeon general. Executive Summary. Rockville, MD: Public Health Service, Office of the Surgeon General. Retrieved from www.fnbha.org/pdf/CultureRaceandEthnicity.pdf
U.S. Department of Health and Human Services. (2011). Health, United States, 2010: With special feature on death and dying. Hyattsville, MD: National Center for Health Statistics, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. Retrieved from http://www.cdc.gov/nchs/data/hus/hus10.pdf
Whitley, R. (2012). “Thank you God:” Religion and recovery from dual diagnosis among low-income African Americans. Transcultural Psychiatry, 49, 87–104. doi:10.1177/1363461511425099
Wilmore, G. S. (1998). Black religion and black radicalism: An interpretation of the religious history of African Americans (3rd ed.). Maryknoll, NY: Orbis Books.
Woodward, A. T. (2011). Discrimination and help-seeking: Use of professional services and informal support among African Americans, Black Caribbeans, and Non-Hispanic Whites with a mental disorder. Race and Social Problems, 3, 146–159. doi:10.1007/s12552-011-9049-z
Janeé R. Avent, NCC, is an Assistant Professor at the University of Texas-San Antonio. Craig S. Cashwell, NCC, is a Professor at the University of North Carolina-Greensboro. Correspondence can be addressed to Janeé R. Avent, 501 César E. Chávez Blvd. DB 4.344, San Antonio, TX 78207, firstname.lastname@example.org.