An interpretative phenomenological analysis of African Caribbean women’s experiences and management of emotional distress Emma J. Sisley DClinPsych 1 , Jane M. Hutton DClinPsych 2 , C. Louise Goodbody DClinPsych 3 and June S.L. Brown PhD 4 1 Department of Applied Psychology, Salomons, Canterbury Christ Church University, Kent, UK, 2 Department of Psychological Medicine, King’s College Hospital, London, UK, 3 Department of Applied Psychology, Salomons, Canterbury Christ Church University, Kent, UK and 4 Institute of Psychiatry, King’s College, London, UK Accepted for publication 8 December 2010 Correspondence Dr Emma J. Sisley Homeopathic Hospital 41 Church Road Tunbridge Wells Kent TN1 1JU, UK E-mail: emma.sisley@kmpt.nhs.uk What is known about this topic d African Caribbean women are under-represented in UK mental health outpatient services and face barriers to accessing support. d Explanatory models of psychologi- cal distress held by individuals may differ from those held by the diagnostic medical model. d Beliefs about emotional distress contribute to help-seeking choices and satisfaction with the services received. What this paper adds d Talking therapies are becoming more acceptable for African Carib- bean women, but access demands persistence or a crisis. d An increase in professional knowl- edge of local resources and signpo- sting would be welcomed. d Media giving information about statutory and voluntary services needs to be more readily available in the community and use language relevant to African Caribbean women. Abstract African Caribbean women are under-represented within mental health services in the United Kingdom, despite sociocontextual vulnerabilities which may increase emotional distress. This qualitative study aimed to explore individual explanatory models of experiences of distress, coping and help-seeking choices, with a view to improving cultural relevance of services. Participants were recruited following their self-referral to self- help community wellbeing workshops. Interpretative phenomenological analysis was carried out following semi-structured interviews with seven African Caribbean women in central London, who reported previously experiencing emotional distress. The study was conducted during 2009. Five super-ordinate themes emerged from the data: explanations of distress, experiences of distress, managing distress, social and cultural influences and seeking help. Each super-ordinate theme consisted of several subthemes which described participants’ experiences. Gender roles and a cultural legacy of being strong and hiding distress emerged as influential in participants’ beliefs about managing personal difficulties. However, this was balanced with an acknowledgement that intergenerational differences highlighted an increasing acceptance amongst the community of talking about issues and seeking professional support. The findings offered support for the notion that understandings and responses to personal distress are subject to broad-ranging and interwoven influences. This complexity may be conceptualised as an ‘exploratory map’ where individuals make links between their current and newly encountered knowledge and experience to guide their personal route to coping and help-seeking. The study provides support for tailoring services to individual needs using a flexible approach which empowers individuals from black and minority ethnic groups by valuing explanatory models of distress alternative to the westernised medical model. Furthermore, findings emphasise the importance of readily available and accessible information about statutory and non-statutory community resources which use language relevant to the communities they are aimed at engaging. Keywords: African Caribbean, distress, explanatory model, exploratory map, women 392 ª 2011 Blackwell Publishing Ltd Health and Social Care in the Community (2011) 19(4), 392–402 doi: 10.1111/j.1365-2524.2010.00986.x