The Use of Ministers for Personal Problems:

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• The Use of Ministers for Personal Problems
• A Focus Group Study of African Americans
• Harold Neighbors, PhD1 Linda Chatters, PhD1
• Phyllis Stillman, BA1 Sophia Hussen, BA1
• Persephone Taylor, BA2 Rashid Njai, BA1
• Natane Singleton, BA1 Robert Taylor, PhD3
• 1School of Public Health
• University of Michigan
• 2Florida State University
• 3School of Social Work
• University of Michigan

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National Survey of Black AmericansUse of
Professional Help

• When asked if sought professional help for the
  stress of a serious personal problem
• Physicians office 10.9
• Emergency room 10.6
• Minister 9.2
• Specialty mental health 4.4
• Social services 3.8

Neighbors H. (1985). Seeking professional help
for personal problems Black Americans' use of
health and mental health services. Community
Mental Health Journal, 21,156-166.
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A Closer Look at Ministers

• No age effects
• Women more likely than men to consult clergy
• bivariate model only
• The more serious the problem the higher the use
  of clergy
• Bereavement problems over three times more likely
  than economic problems to consult clergy
• Interpersonal problems twice as likely as
  economic problems to seek help from clergy

Neighbors H, Musick M, Williams D. (1998). The
African American minister Bridge of barrier to
mental health care? Health Education Behavior,
25, 759-777.
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Exploratory Research Questions

• METHODOLOGICAL
• Challenges to large qualitative data collections
• Data management issues
• Data analysis issues Using qualitative software
• SUBSTANTIVE
• What kinds of problems are taken to clergy?
• Why do people go to clergy for help?
• What kind of help is offered by clergy?
• What barriers to seeking the help of clergy?
• Are there gender differences in clergy use?
• Are there age differences in clergy use?

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Eligibility and Recruitment

• African American men and women
• 18 years and older (age range)
• Christian
• Some degree of religiosity
• Recruitment procedures
• Flyers posted in local businesses
• Church activity groups and bulletins
• Senior citizen centers
• Personal referrals from ministers and research
  staff

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Initial Study Design
CONTROL VARIABLES CONTROL VARIABLES CONTROL VARIABLES CONTROL VARIABLES
Race All participants African American All participants African American All participants African American
Religiosity All participants religious All participants religious All participants religious
BREAK VARIABLES BREAK VARIABLES BREAK VARIABLES BREAK VARIABLES
Gender Gender
Age Female Male TOTALS
18-54 years 3 groups 3 groups 6 Groups
55 years 3 groups 3 groups 6 Groups
TOTAL GROUPS 6 groups 6 groups 12 Groups
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AGE 18-54 years 18-54 years 55 years 55 years
GENDER Female Male Female Male
Date May 22 May 18 July 27 July 8
Participants 7 8 7 3
Date July 1 June 29 July 21
Participants 5 6 5
Date July 27 July 6
Participants 7 9
Date July 31 July 17
Participants 5 5
Date Sep 18 July 22
Participants 7 4
TOTALS 5 groups 5 groups 2 groups 1 group 13
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Data Collection, Transcription, and Data Cleaning

• Two tape recorders used to minimize missing data
• Participants provided with name tents with
  assigned numbers to track who was speaking
• Note Taker provided transcriptionist with list
  indicating each speaker by recording their number
  and their first few words
• Tapes transcribed using notes
• Transcript checked by different person
• Checker listened to tape while reading transcript
• Second check done if multiple mistakes found
  during first check

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Development of Coding Scheme

• Read-through of selected focus group transcripts
• Identified text segments (chunks) as discrete
  meaningful stand-alone thoughts and arguments
• Chunks summarized independently by two coders
  using one or two word codes
• Coders compared notes discussion of differences
• Coders reached consensus on three general codes
• Wrote definitions for each code category
• Why Go Reasons for seeking a ministers
  assistance
• Type of Help Descriptions of help provided by
  ministers
• Why Not Go Barriers to the use of a minister

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Data Analysis using ATLAS.ti

• ATLAS chosen based on ease of use, capacity for
  handling large amounts of data and automation
  variety
• Transcripts prepared for ATLAS
• Margins changed to allow display of codes on
  right
• Saved as .txt files
• Coding List imported into ATLAS
• Used ATLAS Code-by-List Code function
• Analysis conducted on 18-54 year old groups
  (N10)
• All 10 Focus group transcripts assigned to one
  ATLAS Hermaneutic Unit (HU) for chunking and
  coding

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Preliminary Findings Females
WHY GO? Marital Counseling
WHY GO? Death and bereavement
WHY GO? Health problems (for prayer)
TYPE OF HELP? Prayer
TYPE OF HELP? Bible study
TYPE OF HELP? Minister should be non-judgmental
WHY NOT GO? Ministers dont deal w/womens issues
WHY NOT GO? Victimized by going to men blamed
WHY NOT GO? Confidentiality concerns Hypocrisy
WHY NOT GO? Ministers too quick to judge
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Preliminary Findings Males
WHY GO? Marital counseling Life counseling
WHY GO? Bereavement Spiritual insight
WHY GO? Confess sins Father figure
WHY GO? Trust/Comfort Avoids stigma of shrink
TYPE OF HELP? Prayer Provide spiritual insight/Bible
TYPE OF HELP? General Advice Encouragement
TYPE OF HELP? Problem-specific advice Sex, money
WHY NOT GO? Shame Self-reliance (macho) Pride
No relationship Ministers not trained for some problems
Avoidance Lack of respect hypocrisy of ministers
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Methodological Conclusions

• Large qualitative data collection is possible
• Rely on personal contacts/networks to recruit
• Still may have mixed success could not test age
  effects
• Older African Americans (55) will need extra
  effort
• Gender considerations (Men) may need extra
  effort
• Will need multiple groups per cell of study
  design
• Focus group is unit of analysis
• How many groups? It depends cost, time, effort
• Inevitable tension between Control Break
  Variables
• How large and complicated can study be?
• Data management manipulation demands are HUGE!
• Use of a software package is recommended
• But do not avoid paper pencil
• e.g., initial read-through and code development

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Methodological Conclusions

• Qualitative data are useful for supplementing
  shortcomings of survey data
• Use of multiple analysts for chunking and coding
• Labor intensive time consuming BE CARFUL!
• Highly structured facilitator protocol useful
• One-time only focus groups yield general
  responses
• Consider use of more assertive facilitator
  probing
• Consider follow-up sessions with same
  participants
• Consider follow-up one-on-one in-depth interviews
  after review of focus group discussions
• Next Steps
• Discussion of preliminary substantive results
  among team
• Generate more detailed coding system

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African American Mental Health Research Program
(AAMHRP)

• Funded by National Institute for Mental Health
  grant MH58565
• Harold Neighbors, PhD AAMHRP Methods Core
  Leader
• (woodyn_at_umich.edu)
• Linda Chatters, PhD AAMHRP Religion Core
  Leader
• Robert Taylor, PhD AAMHRP Religion Core Leader
• James Jackson, PhD AAMHRP Principal
  Investigator
• For information contact
• The Program for Research on Black Americans
• Institute for Social Research
• University of Michigan
• Ann Arbor, MI 48104-1248
• [phone]

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Female Focus Group Quotes

• What For
• Sometimes you just need to talk things out and
  you need to hear reassurance, and the good thing
  about the pastor is that they know you, they care
  about you, they know your situation. They know
  your situation more than the counselor.
• What Did
• Sometimes we dont get it. You know, the bible
  constantly giving revelations. Read the same
  scripture 20 times. So I think that, by his
  training, that helps me in whatever I need to
  cope with or deal with.
• Why Not
• Theres like a big gap with helping African
  American women in church because they tend to
  look at us like, Just do what your husband
  said. Or You must be the problem if youre
  having the problem.

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Male Focus Group Quotes

• What For
• I dont know if it is media based or just the way
  I grew up in the hood but there is a stigma of
  going to see a shrink. However, in our church
  there is no stigma associated with going to see
  the pastor.
• What Did
• Other times, man, he (the pastor) just like,
  Look, what you need to do is get a job. Hes
  like, You need to work. The Bible is not spooky,
  you know. It says if a man doesnt work, he
  doesnt eat.
• Why Not
• The reason I dont talk to my pastor is because
  some of the things I want to talk to him about, I
  know he aint going to tell me what I want to
  hear.

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Selected Publications

• Neighbors H, Williams D. (2000). The Epidemiology
  of Mental Disorder among African Americans
  1985-2000. In R Braithwaite S Taylor (Eds.),
  Health Issues in the Black Community. San
  Francisco Jossey-Bass, Inc.
• Chatters L. (2000). Religion and Health Public
  Health Research and Practice. Annual Review of
  Public Health, 21, 335-367.
• Taylor R, Mattis J, Chatters L. (1999).
  Subjective religiosity among African Americans A
  synthesis of five national samples. J Black
  Psychology, 25, 524-543.
• Jackson J, Chatters L, Taylor R. (1993). Aging in
  Black America. Sage Publications, Inc.
• Neighbor H, Jackson J. (1996). Mental Health in
  Black America. Sage Publications, Inc.
• Jackson J, Chatters L, Taylor R. (1997). Family
  Life in Black America. Sage Publications, Inc.