RAND just made an article available (previously published) on a culturally specific intervention for African American drug addicts. Bill White has written about several groups that frame addiction recovery as an act of cultural resistance. Locally, I’ve also seen the power of a minority faith community in holding culturally specific recovery events–Rabbi Yisrael Pinson holds monthly recovery Shabbat.
What I found interesting was the idea of doing the intervention over a meal. I’d imagine that this alone would have the potential to dramatically change the dynamics in all sorts of positive ways. Culture aside, this would be a fun model to experiment with.
The content and format of our intervention were designed to be congruent with cultural values of communalism and group process and to employ motivational intervention techniques appropriate for participants at the precontemplation or contemplation stage of change. We began with a traditional African American meal (fried chicken or ribs, greens, potatoes, red beans and rice), which served as a culturally specific frame for the intervention. For this meal, the participant was joined by an intervention team consisting of one counselor and a former drug user, whom we called a peer. This group then watched a 15-minute video, which combined voice-over with still photos, original and documentary footage, and clips from commercial films about African Americans. (Permission to use clips was obtained from holders of the copyrights.) The final step was a counseling session to review the participant’s interest in recovery and service needs. It was based on issues, thoughts, and emotions expressed by the participant during the meal or video.
In the video and counseling session, drug use was represented as both a personal problem and a community problem rooted in cultural and power disparities between the African American community and dominant institutions. Moreover, discussion acknowledged the totality of one’s life experience (e.g., racial prejudices, self-image issues, and job opportunities) not only as an individual but also as an African American. It was emphasized that behavior change is important not only for the individual but also for the collective good.
The peer role was to share personal thoughts and experiences similar to those mentioned by the participant and to demonstrate to him or her that it was both safe and appropriate to speak honestly about one’s drug use experiences and one’s ambivalence regarding recovery. In addition, the peer converted the standard one-on-one format in which a counselor interviews a client to a culturally congruent group process format in which counselor and peer actively affirm the thoughts, feelings, and experiences invoked by the participant.