Meera Rao-Bette MS, LPC
To increase knowledge about Asian immigrants to the U.S. To improve understanding of the issues related to acculturation and enculturation To emphasize common cultural norms within the Asian community To increase awareness of the expectations of Asian clients coming to therapy To highlight clinical approaches that will ensure continued participation of Asians in therapy
1790 to 1860 White and Black 1870 - White, Black, American Indian and Asian (Chinese & Japanese) 1910 - Hindu, Korean, Filipino & Maori 1920 Chinese, Japanese, Filipino, Hindu, Korean, Hawaiian, Malay, Siamese, Samoan, Maori
American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White
Asia is the largest continent on Earth It constitutes nearly 1/3 of Earth s landmass It has about 60% of the world's population (4.3 billion in 2013) Asian Americans constitute one of the fastest growing population groups in the United States Approximately 4.2% of the US population is of Asian descent.
Afghanistan, Bahrain, Bangladesh, Bhutan, Brunei, Cambodia, China, East Timor, India, Indonesia, Iran, Iraq, Israel, Japan, Jordan, Kazakhstan, Korea North, Korea South, Kuwait, Kyrgyzstan, Laos, Lebanon, Malaysia, Maldives, Mongolia, Myanmar (Burma), Nepal, Oman, Pakistan, The Philippines, Qatar, Russia, Saudi Arabia, Singapore, Sri Lanka, Syria, Taiwan, Tajikistan, Thailand, Turkey, Turkmenistan, United Arab Emirates, Uzbekistan, Vietnam, Yemen
1840s - Asian immigrants arrived from China 1890s - the second wave - Japanese 1973 Highly educated immigrants from China, India, Korea and Philippines. Refugees from the Vietnam war 1993 Less educated and unskilled immigrants
Time Long standing immigrant Recent immigrant Method Voluntary Refugees
Acuturation Enculturation
Filial piety Respect for elders Importance of family & community Shame and guilt Saving face
Less autonomous and assertive More conforming, dependent, inhibited Obedient to authority Strong self-control and self-discipline
Quiet and passive Avoid offending Answer all questions affirmatively to be polite Silence Avoid eye contact
Only 17% seek help for psychological issues <6% seek help from a mental health provider High drop out rate
Enhancing therapists multicultural competence Increasing the therapists awareness of their assumptions, values and biases regarding Asians Understanding the worldview of the culturally different client Developing appropriate intervention strategies and techniques. Examining clients cultural attitudes Find ethnic & linguistic match for client
Therapist is the expert Therapist will give advice Therapist will set goals
Display Expertise and Authority Use professional title Display diplomas and licenses Maintain formalism Mention prior experiences Suggest to the client some possible reasons or explanations for their problem Give impression that a solution (cure) to the problem is possible Emphasize concrete and tangible goals Avoid comments that suggest the client will need to be in therapy for a long period of time
Stigma Shame & Guilt Saving Face
Understanding the First Session as a Crisis Hospitalization Alternative Care Services Providing Concrete and Tangible Advice Wait Until the Client Is Ready Understanding expression of Mental Problems in Somatic Terms
Assess for Trauma/PTSD Be sensitive to Hx of racism & discrimination Negotiation not confrontation Avoid Talk Therapy Consider age and status
Family Therapy must be problem focused goal oriented symptom relieving Do not emphasize internal conflicts acquisition of insight self-assertion expression of anger
By Gibbs and Huang (1989) provides a framework for counseling with Asian American families in a culturally-responsive manner. Erikson s (1959) stage theory of psychosocial development Bronfenbrenner s (1979) ecological perspective A cross-cultural perspective on understanding minority mental health
Involves three phases: Finding common ground Structuring family meetings Follow-up
Promotion campaigns Flyers Pamphlets Launch youth programs in schools Hold workshops Participate in community festivals Set up crisis hotlines Provide Counseling Legal advice Social services