Sue & Sue ch. 16 Counseling Asian Americans and Pacific Islanders

Characteristics and Strengths

Asian Americans: A Success Story?

• Over half of Asian Americans have a bachelor's degree (30% of whites do)
• 20% have an advanced degree (10% of whites do)
• Lowest high school dropout rate (2%)
• Median income is $64,308 compared to $49,445 for whites
• Does not take into account the fact that more Asian-American families have dual income
• They also have an overall higher level of poverty than whites (especially Hmong, Guamanian, Indonesian, and Cambodian immigrants) 
• Asian Americans underutilize mental health services (cultural? inaccessibility of resources? etc.)
• experience of discrimination throughout history and current.

Look behind the success myths to understand the clients' historical and current experiences of being an Asian American.

Collectivistic Orientation

• Be aware of the cultural values. Many Asian American families may look enmeshed. Make sure to ask something like: "How does your family see the problem?"

Hierarchical Relationships

• Males and elders occupy a higher status. Definitely more traditional (and different groups vary- Filipino families are more egalitarian with Korean families more patriarchal, etc.)
• Determine family structure and communication pattern. 
• If structure is unclear- address the father first and then the mother to be most productive 
• Maybe having each person in the family address the therapist may be most effective. 

Parenting Styles

• They tend to be more authoritarian and directive than Euro-American families
• Shame, guilt induction, and love withdrawal are often used to control and train children
• Criticism rather than praise is believed to be effective in changing behaviors.
• Western-style/egalitarian parent-effectiveness training strategies may run counter to traditional child-rearing patterns.

Emotionality

• Large/public displays of emotion are not celebrated. It is seen as a lack of self control and maturity
• If a client shows discomfort in a session, instead of saying "you look uncomfortable" it may be more acceptable for the client if you say "This situation would make someone uncomfortable"
• Asian Americans may also may not be as verbal about love- showing it through actions instead of saying "I love you"

Holistic View on Mind and Body

• They may express emotional problems through somatic complaints because physical problems are culturally accepted. 
• Treat somatic complaints as real problems and ask "Dealing with headaches and dizziness can be quite troublesome; how are these affecting your mood or relationships with others?"
• Deal with the somaticism and the consequences of being "ill"

Academic and Occupational Goal Orientation

• Asian American children have higher academic performance but also have higher report of feeling isolated, depressed, and anxious and report little praise for their accomplishments from their parents. 
• Sometimes parents and children have different ideas about what the kids should do. In therapy you could work with the client to brainstorm ways to present other possibilities to the parents. 

Cultural Strengths

• Family orientation
• Collectivity
• Harmony in family relationships 
• Respect for elders

Specific Challenges

Racial Identity Issues

• Asian Americans are often placed in situations of extreme culture conflict and experience pain and agony regarding behavioral and physical differences. 
• Asian American college women report lower self-esteem and less satisfaction with their racially defined features than caucasian. 
• Individuals undergoing acculturation conflicts may respond in the following manner:
• Assimilation (wanting to be part of the dominant society and excluding the dominant group)
• Separation or enculturation (ID with Asian culture)
• Integration/biculturation (retaining may asian values and learning skills and values to adapt to dominant culture)
• Marginalization (Perceiving one's own culture as negative but feeling inept at adapting to the majority culture)

Acculturation Conflicts

• The issue of not quite fitting in with their peers yet being considered "too Americanized" by their parents is common. 
• Parent-child conflicts are among the most common problem. The larger the acculturation gap between parents and children- the more conflict.
• Reframe these differences and problems as due to acculturation problems
• Therapist can function as a culture broker in helping the family negotiate conflicts with larger society

Expectations Regarding Counseling

• It's important to carefully explain therapy and treatment because psychotherapy may be a foreign concept for many. 
• Be careful not to impose techniques or strategies
• What is expected by Asian clients in an active role by counselor in structuring the session and guidelines on types of responses that they will be expected to make.
• Clearly describe client's role in therapy process
• Therapist should direct therapy sessions but should ensure full participation from clients in developing goals and intervention strategies. 

Racism and Discrimination

• Assess the effects of possible environmental factors on mental health issues in Asian Americans and help insure that clients not internalize issues based on discriminatory practices.