A comparison between the participants and the non-participants on age, highest level of education, occupation, and marital status indicated the two groups were similar. Particularly important was the similarity in anxiety background. Contingency Table Chi Square analysis indicated that the anxiety background experience of participants and non-participants was minimally different as both X2 values were less than 1.0. Therefore, it appears that our sample was not different from the population of professional African American women invited to participate. Most women (65%) who declined participation did so because the meeting time for the focus groups was not convenient.
The Focus Group Experience
When asked to evaluate their focus group experience, most participants rated it as “very positive” (M = 9.0, SD = 1.2). A higher positive response (M = 9.3, SD = 1.0) was given when asked if the participants felt they had been able to share their ideas and suggestions. The majority(88.2%) said “Yes” to future participation, the remaining(11.8 %) said “Maybe.”
Professional Black Women’s Perceptions of Panic and Anxiety
Participants were asked how they defined the terms “anxiety” “anxiety attack” and “panic attacks.” presents a summary of the major themes that emerged. Anxiety and panic attacks were characterized by physical symptoms/reactions, as well as overwhelming fear and emotions. A number of other responses emerged within individual groups.
Major emergent themes concerning anxiety and panic attacks.
“I see that a little differently. I see it like anxiety attack is, is like a real low level. When I read panic attack, I just think of somebody that’s way up here as, as opposed to having some anxiety about an issue. When I think of panic, I just think out of control, immobilized that kind of thing.”
When soliciting definitions from the focus groups, one group agreed that the definition provided in the focus group booklet, that is, “Panic attacks are the sudden onset of intense anxiety, characterized by feelings of intense fear and apprehension accompanied by palpitations, shortness of breath, sweating and trembling.” Two groups provided extensions of the definition and saw a panic attack as a person “being immobilized.” The fourth group also stressed the difference between anxiety and panic. Interestingly, the groups did not perceive panic attack as prevalent among African American women, as demonstrated by the following:
“Well, I would say one or two [panic attacks experienced] because the only women that I’ve known who have had panic attacks have not been African American women”
When asked what causes anxiety and panic attacks in professional African American women, a variety of responses emerged. Causes identified included expectations, lack of support, pressure and insecurities.
“I think another reason it is because we don’t use our support systems. Or we don’t have really good support systems in our lives, so everything is dependent upon us to do it or get it done. Or we don’t delegate, which is something we don’t do a lot.”
Women judged the long-term effects of panic attacks and anxiety to be mental and physical health decrements. At least nine of the participants indicated they had experienced a panic attack; four others reported witnessing a panic attack.
Feasibility of Sister Circles
A primary aim of the focus group process was to examine the feasibility of sister circles as a psycho-educational intervention for African American professional women. As seen in , a variety of questions posed to the focus groups generated responses that provide qualitative data that support feasibility. Specific suggestions concerning aspects of making a sister circle successful were offered.
When asked about the types of programs/services African American women might need to help cope with anxiety and panic attacks, community and church “support groups” were frequent responses by participants in the focus groups. One focus group even used the term “sister circle” in their response
“The sister circle that I mentioned, I wasn’t just speaking in terms of sister friends um there’s a meeting tonight and I’ve been apart of it for eight years where um sister circle meets on the first and third Monday of the month, every month and there’s approximately twenty-five women that participate on a regular basis um, it’s seventy-five women but you know, they just come and go. But, those kind of forums where we talk freely like this and we um establish the un-guarded rule where I can say whatever I feel like saying and it doesn’t go out of this circle and if it’s heard that it has and you said it, then you’re not invited back. So that allows people to feel like they can let their guard down and share freely. And so, things like that are important.”
A consistently reported challenge to seeking help was the “stigma” others attached to a help seeking process especially for professionals. Women agreed that there is a stigma attached to seeking mental health services and this stigma may be intensified for professional women.
“There’s some people that can allowed, that you allowed to be transparent but when you’re a leader in, in, in a community, um a lot of times um, um, um a weakness will destroy your credibility as a, a leader”
Sister circles however, were seen as having less stigma because they are perceived as a “natural” endeavors for African American females.
“I like the concept because to me it mirrors what I’m trying to do and that is provide a forum for women of color and that in this case is, more specifically African-Americans to share experiences often. Like this is meaningful to me because it’s the same thing, I’m not the only one in the room having panic attacks or feeling overwhelmed you hit it on the head for me, like wow, that’s exactly what I felt like.”
For a sister circle to be successful, a number of requirements were expressed by focus groups. The most prevalent were that the sister circle be confidential and that time was an important concern.
“And I would be um, you mentioned a good word, confidentiality. You would want to know that it was a confidential setting.”
Some resistance to doing “homework” as part of the sister circle intervention was stated.
“Cause when you give someone homework, that’s like a task, they’re supposed to perform that’s going to add more stress.”
Ninety-one percent of the FG participants felt the sister circle size should be between 5 and 10 members. Two groups validated the concept of the sister circle approach and the need to get involved and share “your story.” Two groups did not have the opportunity to answer the question
Sister Circles as a Psycho-Educational Intervention
A sub-goal for the focus group process was to generate information regarding the theory that sister circles would work as a psycho-educational intervention for African American women. Focus group participants expressed confidence in the potential effectiveness of sister circles a way to deal with anxiety and panic attacks. Participants viewed sister circles as an outgrowth of existing relationships with other professional women at work or church. One group saw sister circles as a natural form of engagement
“I just had a question. Well, whether or not it’s informal or formal? Just because I have, I think I have friends that I treat, I think we kind of do this thing but it’s an informal.” “Church groups, like a church type, you know. Some type of church program or retreat type program”
When asked how effective participants viewed sister circles’ potential in assisting women with managing anxiety and panic attacks, the group’s response was quite positive (M = 8.8, SS = 1.5).