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16
Counseling Asian Americans
and Pacific Islanders
Chapter Objectives
1.
Learn the demographics and characteristics of Asian Americans and
Pacific Islanders.
2.
Identify counseling implications of the information provided for
Asian Americans and Pacific Islanders.
3.
Provide examples of strengths associated with Asian Americans and
Pacific Islanders.
4.
Know the special challenges faced by Asian Americans and
Pacific Islanders.
5.
Understand how the implications for clinical practice can guide assess
ment and therapy with Asian Americans and Pacific Islanders.
501
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502
COUNSELING THE CULTURALLY DIVERSE
Among traditionally oriented Chinese Americans, depression is
described with terms such as discomfort, pain, dizziness, or other
physical symptoms, rather than as feelings of sadness. Many feel that a
diagnosis of depression is “morally unacceptable.” (Kleinman, 2004)
Asian parents hold dearly to the centuries-old culture of shame and
honor so that when they arrive to the United States, it often gets
passed down to the next generation. So much so that if their children
need help for issues related to low self-esteem, depression, anxiety,
or any personal struggles, they can be seen as tarnishing the family’s
prestige. (Louie, 2014a)
Calling Asian Indians the new “model minority” isn’t a compliment.
It’s an attempt to fit them into a box for political purposes. . .The
phase “model minority” inherently pits one minority group against
others . . . After all, if one community is the “model, “ then the others
are problematic and less desirable. (Srivastava, 2009, p. 1)
The Asian American population is growing rapidly and, as of 2013, was close
to 18 million, representing 5.3% of the total population. Native Hawaiian and
other Pacific Islanders number 1.2 million and comprise 0.4% of the total popu
lation (U.S. Census Bureau, 2015). The largest Asian groups in the United States
include
(Pew Research Center, 2013)
• over 4 million Chinese,
• 3.4 million Filipinos,
• 3.2 million Asian Indians,
• 1.7 million Vietnamese,
• 1.6 million Koreans, and
• 1.3 million Japanese.
Nearly three-quarters of Asian American adults were born abroad and about
two-thirds speak a language other than English at home; approximately half
do not speak English “very well.” Between-group differences within the Asian
American population are quite large, since the population is composed of at least
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CHARACTERISTICS AND STRENGTHS
503
40 distinct subgroups that differ in language, religion, and values. Counselors
should not assume that Asian Americans are all the same. Individuals diverge on
variables such as ethnicity, culture, migration and relocation experiences, degree
of assimilation or acculturation, identification with the home country, facility
in their native language and in English, family composition, educational back
ground, religion, and sexual orientation (Nadal et al., 2012).
CHARACTERISTICS AND STRENGTHS
In the following section, we present some of the cultural values, behavioral char
acteristics, and expectations that Asian Americans might have about therapy and
consider the implications of these factors in treatment. The level of accuracy of
these group generalizations for each individual client or family must be deter
mined by the therapist.
Asian Americans: A Success Story?
The contemporary image of Asian Americans is that of a highly successful minority
that has “made it” in society. Indeed, a close analysis of census data (U.S. Census
Bureau, 2011a) seems to support this contention. Of those over the age of 25, over
half of Asian/Pacific Islanders have a bachelor’s degree, versus 30% of their White
counterparts; 20% have an advanced degree, compared with 10% of Whites (U.S.
Census Bureau, 2011b). Words such as intelligent, hardworking, enterprising, and
disciplined are frequently applied to this population (Lim, 2014). The median
income of Asian American families was $66,000 as compared with $49,800 for
the U.S. population as a whole (Pew Research Center, 2013).
However, a closer analysis of the status of Asian Americans reveals a some
what different story. First, in terms of economics, references to the higher median
income of Asian Americans do not take into account (a) the higher percentage of
Asian American families having more than one wage earner, (b) between-group
differences in education and income, and (c) a higher prevalence of poverty despite
the higher median income (12.5% for Asian Americans and 15.1% for Pacific
Islanders, versus 9.4% for non-Hispanic Whites) (U.S. Census Bureau, 2010).
Rates of poverty are particularly high among Hmong, Guamanian, Indonesian,
and Cambodian immigrants (Ramakrishnan & Ahmad, 2014).
Second, in the area of education, Asian Americans show a disparate pic
ture of extraordinarily high educational attainment among a few and a large,
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504
COUNSELING THE CULTURALLY DIVERSE
undereducated mass. Among the Hmong, only 40% have completed high school.
Fewer than 14% of Tongan, Cambodian, Laotian, and Hmong adults and only
18% of Pacific Islanders have a bachelor’s degree (Aronowitz, 2014). When aver
aged out, this bimodal distribution indicates how misleading statistics can be.
Third, there is now widespread recognition that Chinatowns, Manilatowns,
and Japantowns in San Francisco and New York represent ghetto areas with prev
alent unemployment, poverty, health problems, and juvenile delinquency. People
outside these communities seldom see the deplorable social conditions that exist
behind the bright neon lights, restaurants, and quaint shops.
Fourth, although Asian Americans underutilize mental health services, it is
unclear if this is due to low rates of socioemotional difficulties or cultural values
inhibiting self-referral (Zane & Ku, 2014). It is possible that a large portion of the
mental illness, adjustment problems, and juvenile delinquency among Asians is
hidden. The discrepancy between official and real rates of adjustment difficulties
may be due to cultural factors, such as the shame and disgrace associated with
admitting to emotional problems, the handling of problems within the family
rather than relying on outside resources, and the manner of symptom formation,
such as a low prevalence of acting-out disorders.
Fifth, Asian Americans have been exposed to discrimination and racism
throughout history and continue to face anti-Asian sentiments. Even fourth- and
fifth-generation Asian Americans are sometimes identified as “foreign” (Tsuda,
2014). In a survey of Chinese Americans, 58% reported being subjected to
verbal harassment such as being made fun of, called names, or threatened; dis
respectful or unfair treatment; unfairness in career advancement; stereotyping;
and physical harassment (Larson, 2009). Perceived racial discrimination is associ
ated with higher psychological distress, anxiety, depression, and suicidal ideation
(Hwang & Goto, 2009).
It is important for those who work with Asian Americans to look behind the
success myth and to understand the historical and current experiences of Asians
in America. The matter is even more pressing for counselors when we realize that
Asian Americans underutilize counseling and other mental health facilities. The
approach of this chapter is twofold. First, we attempt to indicate how the inter
play of social and cultural forces has served to shape and define the lifestyle of
recent immigrants/refugees and American-born Asians. Second, we explore how
an understanding of Asian American values and social experiences suggests a need
for modifications in counseling and psychotherapeutic practices when working
with some members of this population.
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CHARACTERISTICS AND STRENGTHS
505
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Collectivistic Orientation
I was born and raised in Korea and came to the United States in
1968. . .I must move back to Seoul to take care of my aging mother.
I am a man of Asian values (filial piety), and my children are young
college graduates of American values (career advancement and devel
opment). (Choi, 1999, p. 7)
Instead of promoting individual needs and personal identity, Asian families
tend to have a family and group orientation. Children are expected to strive for
family goals and not engage in behaviors that might bring dishonor to the fam
ily. Parents believe they should have influence on their children’s career choices
(Pew Research Center, 2013). Asian American parents tend to show little inter
est in children’s viewpoints regarding family matters. Instead, the emphasis is on
adherence to “correct” values, family harmony, and adapting to the needs of fam
ily members, especially elders (P. H. Chen, 2009). Asian American adolescents
are often expected to assist, support, and respect their families even when exposed
to a society that emphasizes adolescent autonomy and independence (Fuligni
et al., 1999).
Whereas EuroAmerican parents rated being “self-directed” as the most import
ant attribute in children’s social competence, Japanese American parents chose
“behaves well” (O’Reilly, Tokuno, & Ebata, 1986). Chinese American parents
also believed that politeness and calmness are important childhood characteristics
(Jose, Huntsinger, & Liaw, 2004). Asian American families do differ, however, in
the degree to which they place individual needs over family needs. For example, in
the case just given, the client accepted the fact that his adult children would not
return home to stay with his wife (their mother) while he was in Korea taking care
of his mother. Although he decries American society, in which individualism pre
vails over collectivism, he acknowledges that his children have honored the family
by being successful and that they define family obligations in a different manner.
Implications
Because of a possible collectivistic orientation, it is important to consider the fam
ily and community context during assessment and problem definition. A thera
pist should be open to different family orientations and to avoid automatically
considering interdependence as a sign of enmeshment. After doing a clientcentered analysis of the problem, counselors can ask, “How does your family see
the problem?” For traditionally oriented Asian Americans, a focus on individual
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506
COUNSELING THE CULTURALLY DIVERSE
client needs and wishes may run counter to the values of collectivism. Goals and
treatment approaches may need to include a family focus (e.g., “How important is
it for you to consult your family before deciding how to deal with the problem?”
and “How would achieving your goals affect you, your family, friends, and social
community?”). Questions such as these allow the therapist to assess the degree of
collectivism in the family. Acculturated Asian Americans with an individualistic
orientation can often benefit from traditional counseling approaches, but family
issues should also be considered, since acculturation conflicts are common.
Hierarchical Relationships
Traditional Asian American families tend to be hierarchical and patriarchal in
structure, with males and older individuals occupying a higher status (Kim, 2011).
Communication flows downward from parents to children; children are expected
to defer to their elders as a matter of obligation and duty (A. Lau, Fung, & Yung,
2010). Sons are expected to carry on the family name and tradition. Even when
they marry, their primary allegiance is to the parents. Between-group differences
do exist. Japanese Americans are the most acculturated. The majority are third- or
fourth-generation Americans. Filipino American families tend to be more egali
tarian, whereas Korean, Southeast Asian, and Chinese American families tend to
be more patriarchal and traditional in orientation (Blair & Qian, 1998). Modern
Chinese societies are moving toward more egalitarian relationships between hus
band and wife and between parents and children (E. W.-C. Chen, 2009).
Implications
Clients should be aware that Asian Americans may respond to the counselor as an
authority figure, be reluctant to express true feelings and concerns, and say what
they think the mental health professional wants to hear (Son & Ellis, 2013). In
family therapy, it is important to determine the family structure and communi
cation pattern. Does it appear to be egalitarian or hierarchical? If the structure is
not clear, addressing the father first and then the mother may be most productive.
If English is a problem, use an interpreter. Having children interpret for the
parents can be counterproductive because it upsets the hierarchical structure. For
very traditionally oriented families, having communication between family mem
bers directed to the therapist may be more congruent with cultural values than hav
ing family members address one another. It is also important to assess possible status
changes within the family. It is not uncommon among Asian immigrants for women
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CHARACTERISTICS AND STRENGTHS
507
to retain their occupational status while men are either underemployed or unem
ployed. Such loss of male status may result in family conflict, particularly if males
attempt to maintain their status by becoming even more authoritarian. In such cases,
it may be helpful to cast societal factors as the problem that needs to be addressed.
Parenting Styles
Amy Chua, author of the book Battle Hymn of the Tiger Mom,
raised a storm of criticism when she described her child-rearing
strategies, including banning sleepovers, play dates, watching TV, or
playing computer games and considering any grade less than an “A”
as unacceptable. Her children are required to complete all of their
school work and must practice their musical instruments three hours
each day. (One daughter, Sophia, played at Carnegie Hall at age 14
and the other daughter, Lulu, is a gifted violinist.) (Corrigan, 2011)
Asian American parenting styles tend to be more authoritarian and direc
tive than those in EuroAmerican families (Kim, 2011), although a relaxed style
is often used with children younger than the age of 6 or 7 (Jose et al., 2004).
For example, Chinese parenting is based on the concepts of chiao shun (to train)
and guan (to govern and to love) (Russell, Crockett & Chao, 2010). Shame, the
induction of guilt, and love withdrawal are often used to control and train the
children (J. S. Lau, Fung, Wang, & Kang, 2009). Problem behavior in children
is viewed as a lack of discipline. While praise is frequently used in the majority
culture to reinforce desired behaviors, many Asian families consider instruction to
be the main parenting strategy (Paiva, 2008). As one parent stated, “I don’t under
stand why I should reward things they should already be doing. Studying hard
is a normal responsibility. Listening to parents is a must. Why should they feel
proud when they are merely meeting a basic obligation?” (A. S. Lau et al., 2010,
p. 887). Criticism rather than praise is believed to be effective in changing behav
iors. However, differences in parenting style between Asian American groups have
been found. Japanese and Filipino American families tend to have the most egali
tarian relationships, whereas Korean, Chinese, and Southeast Asian Americans are
more authoritarian (Blair & Qian, 1998).
Implications
Egalitarian or Western-style parent-effectiveness training strategies may run
counter to traditional child-rearing patterns. Traditional Asian American families
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508
COUNSELING THE CULTURALLY DIVERSE
exposed to Western techniques or styles may feel that their parenting skills are
being criticized. Instead of attempting to establish egalitarian relationships, the
therapist can focus on identifying different aspects of parenting, such as teaching
and modeling. The therapist can help refocus on the more positive aspects of Asian
child-rearing strategies, framing the change as helping the children with problems
rather than altering traditional parenting. It is also important to commiserate with
parents regarding the difficulties they encounter raising children in a society with
different cultural standards (A. S. Lau, 2012).
Emotionality
Patients may not be willing to discuss their moods or psychological
states because of fears of social stigma and shame. In many Asian
cultures, mental illness is stigmatizing; it reflects poorly on family
lineage and can influence others’ beliefs about the suitability of an
individual for marriage. (Louie, 2014b)
Strong emotional displays, especially in public, are considered signs of imma
turity or lack of self-control; control of emotions is considered a sign of strength
(Kim, 2011). Thus, in many Asian families, there is generally less open display of
emotions. Instead, care and concern are shown by attending to the physical needs
of family members. Fathers frequently maintain an authoritative and distant role
and are not generally emotionally demonstrative or involved with children. Their
role is to provide for the economic and physical needs of the family. Mothers are
more responsive to the children but use less nurturance and more verbal and phys
ical punishment than do EuroAmerican mothers (Kelly & Tseng, 1992). How
ever, mothers are expected to meet the emotional needs of the children and often
serve as the intermediary between the father and the children. When the children
are exposed to more open displays of emotions from Western society, they may
begin to question the comparative lack of emotion displayed by their parents.
Implications
Counseling techniques that focus directly on emotions may be uncomfortable and
produce shame for traditional Asian Americans. Emotional behavior can be rec
ognized in a more indirect manner. For example, if a client shows discomfort, the
therapist could respond by saying either “You look uncomfortable” or “This situ
ation would make someone uncomfortable.” In both cases, the discomfort would
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CHARACTERISTICS AND STRENGTHS
509
be recognized. We have found that many Asian Americans are more responsive
to the second, more indirect acknowledgment of emotions. Feelings of shame
or embarrassment may interfere with self-disclosure and need to be addressed in
counseling. The process may be facilitated by affirming that the sharing of personal
information, although it may be uncomfortable, is a natural process in therapy
(Zane & Ku, 2014). It is also helpful to focus on behaviors more than emotions
and to identify how family members are meeting each other’s needs. Among tradi
tional Asian American couples, care and concern may be demonstrated by taking
care of the physical needs of the partner rather than by verbally expressing con
cern. Western therapies that emphasize verbal and emotional expressiveness may
not be appropriate in work with traditional Asian couples or families.
Holistic View on Mind and Body
A female Asian American client described her symptoms, including
dizziness, loss of appetite, an inability to complete household chores,
and insomnia. She asked the therapist if her problem could be due
to “nerves.” The therapist suspected depression, since her symptoms
included many of the physical manifestations of the disorder. She
asked the client if she felt depressed and sad. At this point, the client
paused and looked confused. She finally stated that she feels very ill
and that these physical problems are making her sad. Her perspective
was that it is natural to feel sad when sick. When the therapist fol
lowed up by asking if there was a family history of depression, the cli
ent displayed even more discomfort and defensiveness. Although the
client never directly contradicted the therapist, she never returned.
(Tsui & Schultz, 1985)
Because the mind and body are considered inseparable, Asian Americans
may express emotional difficulties through somatic complaints (Grover & Ghosh,
2014). Physical complaints are a common and culturally accepted means of
expressing psychological and emotional stress. It is believed that physical prob
lems cause emotional disturbances and that symptoms will disappear once the
physical illness is treated. Instead of mentioning anxiety or depression, Asian cli
ents often mention headaches, fatigue, restlessness, and disturbances in sleep and
appetite (Wong, Tran, Kim, Kerne, & Calfa, 2010). Even psychotic patients typ
ically focus on somatic complaints and seek treatment for these physical ailments
(Nguyen, 1985).
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COUNSELING THE CULTURALLY DIVERSE
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Implications
Treat somatic complaints as real problems. Inquire about medications or other treat
ments that are being used to treat the symptoms. To address possible psychological
factors, counselors can ask questions such as, “Dealing with headaches and dizzi
ness can be quite troublesome; how are these affecting your mood or relationships
with others?” This approach both legitimizes the physical complaints and allows an
indirect way to assess psychosocial factors. It is beneficial to develop an approach
that deals with both somatic complaints and the consequences of being “ill.”
Academic and Occupational Goal Orientation
I want to write. I have to write. . . This is not the choice my par
ents would make, and surely not the choice they would wish me to
make. . .I must not let it deter my progress or shut down my dreams,
my purpose. (Ying, Coombs, & Lee, 1999, p. 357)
There is great pressure for children to succeed academically and to have a
successful career, since both are indicative of a successful upbringing. As a group,
Asian Americans perform better academically than do their EuroAmerican coun
terparts. Although Asian American students have high levels of academic achieve
ment, they also have more fear of academic failure and spend twice as much time
each week studying as their non-Asian peers (Eaton & Dembo, 1997). Their
achievement often comes with a price. Asian American adolescents report feeling
isolated, depressed, and anxious, and report little praise for their accomplishments
from their parents (Lorenzo, Pakiz, Reinherz, & Frost, 1995). Asian American
parents often have specific career goals in mind for their children (generally in
technical fields or the hard sciences). Because choice of vocation may reflect paren
tal expectations rather than personal talent, Asian college students are sometimes
uncertain about realistic career options (Lucas & Berkel, 2005). Deviations from
either academic excellence or “appropriate” career choices can produce conflict
with family members.
Implications
Counselors can inquire about and discuss conflicts between parental academic or
career goals and the client’s strengths, interests, and desires. When working with
parents, counselors can encourage the recognition of all positive behaviors and
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SPECIFIC CHALLENGES
511
contributions made by their children, rather than just academic performance. For
career or occupational conflicts, counselors can acknowledge the importance par
ents place on their children achieving success, while indicating that there are many
career options that can be considered. Differences of opinion can be presented
as a culture conflict. The counselor can help the client brainstorm ways to pres
ent other possibilities to the parents. Because Asian American students often lack
clarity regarding vocational interests, they may need additional career counseling
assistance (Lucas & Berkel, 2005).
Cultural Strengths
Asian Americans’ cultural values can provide resiliency and strength. The family
orientation allows members to achieve honor by demonstrating respect for parents
and elders and supporting siblings in their endeavors. These customs produce a
collective support system that can shield the individual and family from sources
of stress. Because the achievements and success of an individual are considered
a source of pride for the family rather than the individual, group harmony is
primary. Enculturation or identification with one’s racial and ethnic background
can serve as a buffer against prejudice, discrimination, and family conflicts (Hwang,
Woods, & Fujimoto, 2010; Kim, 2011). For Korean American adolescents, ethnic
identity pride is positively related to self-esteem, especially when there is strong
parental support (Chang, Han, Lee, & Qin, 2015).
Pacific Islanders have faced a history of colonization and oppression. Despite
these challenges and obstacles, cultural strengths such as collectivity, harmony in
family relationships, and respect for elders have been an important source of resil
ience. Pacific Islanders can rely on the community and family during times of
stress (Vakalahi, 2009). Korean American college students were found to have
strong cognitive flexibility. In dealing with conflicts with parents, these individ
uals used creative means to prevent or resolve problems in a way that accommo
dated traditional cultural expectations and their own personal needs (Ahn, Kim,
& Park, 2009).
SPECIFIC CHALLENGES
In the following sections we describe the challenges often faced by Asian Ameri
cans and consider their implications in treatment.
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COUNSELING THE CULTURALLY DIVERSE
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Racial Identity Issues
White privilege was a concept I was unaware of, even though it was
intricately woven into the fabric of my life. If someone had asked me
then, I would probably have said that I have not experienced racism,
and I did not feel oppressed in any way. This is not to say I had not
experienced racism. I just never thought of those encounters as racism
because, most of the times, they were subtle. I reacted to racial microaggressions with confusion, fear, and frustration, although I never
understood my emotions. (Lo, 2010, p. 26)
As Asian Americans are progressively exposed to the standards, norms, and
values of the wider U.S. society, the result is increasing assimilation and accul
turation. Bombarded on all sides by peers, schools, and the mass media, which
uphold Western standards, Asian Americans are frequently placed in situations
of extreme culture conflict and experience distress regarding their behavioral and
physical differences (Kim, 2011). Asian American college women report lower
self-esteem and less satisfaction with their racially defined features than do their
Caucasian counterparts (Mintz & Kashubeck, 1999). C.-R. Lee (1995) described
his experiences as “straddling two worlds and at home in neither” and tells how he
felt alienated from both American and Korean cultures. As with other adolescents,
those of Asian American descent also struggle with the question of “Who am I?”
In the case above, Lo talks about the struggles encountered during his racial iden
tity development. Individuals undergoing acculturation conflicts may respond in
one of the following ways (Huang, 1994):
1. Assimilation. Seeking to become part of the dominant society to the exclusion
of one’s own cultural group
2. Separation or enculturation. Identifying exclusively with the Asian culture
3. Integration/biculturalism. Retaining many Asian values while simultaneously
learning the necessary skills and values for adaptation to the dominant culture
4. Marginalization. Perceiving one’s own culture as negative but feeling inept at
adapting to the majority culture
Implications
Although identity issues can be a problem for some Asian Americans, others believe
that ethnic identity is not salient or important. Assessing the ethnic self-identity
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SPECIFIC CHALLENGES
513
of clients is important because it can affect how we conceptualize the presenting
problems and how we choose the techniques to be used in therapy. Those who
adhere to Asian values have a more negative view toward seeking counseling (Kim,
2007). Acculturated Asian American college students hold beliefs similar to those
of counselors, whereas less acculturated students do not (Mallinckrodt, Shigeoka,
& Suzuki, 2005). Assimilated Asian clients are generally receptive to Western
styles of counseling and may not want reminders of their ethnicity. Traditionally
identified Asians are more likely to be recent immigrants who retain strong cul
tural values and are more responsive to a culturally adapted counseling approach.
Bicultural Asian Americans adhere to some traditional values, while also incorpo
rating many Western values. Being bicultural is associated with resilience in facing
stressful situations (Sirikantraporn, 2013). Programs that help Asian American
youth develop social awareness about ethnic identity issues and societal imbal
ance in power are associated with increased pride, self-efficacy, racial and ethnic
esteem, and increased interest in contributing to societal change in its participants
(Suyemoto, Day, & Schwartz, 2015).
Acculturation Conflicts
Children of Asian descent who are exposed to different cultural standards often
attribute their psychological distress to their parents’ backgrounds and different
values. 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 presenting problems for Asian American college students seeking
counseling (R. M. Lee, Su, & Yoshida, 2005) and are often related to dating and
marriage issues (Ahn, Kim, & Park, 2009). Chinese immigrant mothers report
a larger acculturation gap with sons than with daughters (Buki, Ma, Strom, &
Strom, 2003). The larger the acculturation gap between parents and children, the
greater the number of family problems. Parents may complain, “My children have
lost their cultural heritage” (Hwang et al., 2010). The inability to resolve differ
ences in acculturation results in misunderstandings, miscommunication, and con
flict (R. M. Lee, Choe, Kim, & Ngo, 2000). Parents may feel at a loss in terms of
how to deal with their children. Some respond by becoming more rigid.
Implications
To prevent negative interpersonal exchanges between parents and their children,
therapists can reframe problems as resulting from acculturation conflicts. In this
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514
COUNSELING THE CULTURALLY DIVERSE
way, both the parents and their children can discuss cultural standards and the
expectations from larger society. Although family therapy would seem to be the
ideal medium in which to deal with problems for Asian Americans, certain dif
ficulties exist. Most therapy models are based on EuroAmerican perspectives of
egalitarian relationships and require verbal and emotional expressiveness. Some
models assume that a problem in a family member is reflective of dysfunction
between family members. In addition, the use of direct communication between
child and parents, confrontational strategies, or nonverbal techniques such as
“sculpting” may be an affront to the parents.
Assess the structure of the Asian American family. Is it hierarchical or more
egalitarian? What is their perception of healthy family functioning? How are
decisions made in the family? How are family members showing respect for each
other and contributing to the family? Focus on the positive aspects of the family
and reframe conflicts to reduce confrontation. Expand systems theory to include
societal factors such as prejudice, discrimination, poverty, and conflicting cultural
values. Issues revolving around the pressures of being an Asian American family in
this society need to be investigated. Describe the session as a solution-oriented one
and explain that family problems are not uncommon. As much as possible, allow
sensitive communications between family members to come through the thera
pist. The therapist can function as a culture broker in helping the family negotiate
conflicts with the larger society.
Expectations Regarding Counseling
Because psychotherapy may be a foreign concept for some Asian Americans, it is
important to carefully explain the nature of the assessment and treatment pro
cess and the necessity of obtaining personal information and insight into family
dynamics. Asian American clients may expect concrete goals and strategies
focused on solutions. Even acculturated Asian American college students prefer
counselors to serve as direct helpers offering advice, consultation, and the facil
itation of family and community support systems (Atkinson, Kim, & Caldwell,
1998). Mental health professionals must be careful not to impose techniques
or strategies. Counselors often believe that they should adopt an authoritar
ian or highly directive stance with Asian American clients. What many Asian
American clients expect is that the counselor take an active role in structuring
the session and outlining expectations for client participation in the counseling
process. It can be helpful for the therapist to accept the role of being the expert
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SPECIFIC CHALLENGES
515
regarding therapy, while the client is given the role of expert regarding his or her
life. In this way, clients can assist the therapist by facilitating understanding of
key issues and possible means of approaching the problem (S.W.-H. Chen &
Davenport, 2005).
Implications
Carefully describe the client’s role in the therapy process, indicating that prob
lems can be individual, relational, environmental, or a combination of these and
that you will perform an assessment of each of these areas. Introduce the concept
of co-construction—that effective counseling involves the client and the coun
selor working together to identify problems and solutions. The therapist might
explain, “In counseling we try to understand the problem as it affects you, your
family, friends, and community, so I will ask you questions about these different
areas. With your help we will also consider possible solutions that you can try
out.” Co-construction reduces the chance that the therapist will impose his or her
worldview on the client.
The counselor should direct therapy sessions but should ensure full participa
tion from clients in developing goals and intervention strategies. Suggestions can
be given and different options presented for consideration by the client. Clients
can also be encouraged to suggest their own solutions and then select the option
that they believe will be the most useful in dealing with the problem. The oppor
tunity for Asian American clients to try interventions on their own promotes the
cultural value of self-sufficiency. The consequences for any actions taken should be
considered, not only for the individual client, but also for the family. The client’s
perspective is also important in determining what needs to be done if cultural or
family issues are involved.
Therapy should be time limited, should focus on concrete resolution of prob
lems, and should deal with the present or immediate future. Cognitive-behavioral
and other solution-focused strategies are useful in working with Asian Ameri
cans (S.W.-H. Chen & Davenport, 2005). However, as with other Eurocentric
approaches, these approaches may need to be altered because the focus is on the
individual, whereas the unit of treatment for Asian Americans may actually be the
family, community, or society. Cognitive-behavioral approaches can be modified
to incorporate a collectivistic rather than an individualistic perspective. For exam
ple, assertiveness training can be altered for Asian clients by first considering pos
sible cultural and social factors that may affect assertiveness (e.g., minority status
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516
COUNSELING THE CULTURALLY DIVERSE
or personal values such as modesty). Then the therapist and client can identify
situations where assertiveness might be functional, such as in class or when seek
ing employment, while recognizing other situations where a traditional cultural
style might be more appropriate (e.g., with parents or other elders). Additionally,
possible cultural or societal influences that affect social anxiety or assertiveness can
be discussed. Finally, the client can practice role-playing to increase assertiveness
in specific situations. This concrete alteration of a cognitive-behavioral approach
considers cultural factors and allows clients to establish self-efficacy.
Racism and Discrimination
Katie also said she had not been “exposed to racism, personally,” defining racism
as making fun of or discriminating against others because one feels superior . . .
“except for those annoying little people that walk around the street and walk by
me and go, ‘ching, chong, ching’ or whatever.” (Suyemoto, Day, & Schwartz,
2015, p. 130)
Asian Americans continue to face issues of racism and discrimination (Hwang
& Goto, 2009). However, some Asian American youth, such as Katie in the previ
ous example, lack awareness of or minimize discriminatory behavior toward them,
describing racial jokes and teasing as unintentional or “just for fun.” Exposure to
racism or discrimination does affect mental health. In a sample of 444 Chinese
American adolescents, it was found that discrimination in early adolescence was
related to depression, alienation, and lower academic performance in middle ado
lescence (Brenner & Kim, 2009). Experience with discrimination in foreign-born
and Asian American–born college students was not only related to depression but
also to intergenerational conflicts, especially with the mother, probably because
she is the one whom family members interact primarily with to navigate social
problems (Chang, Chen, & Cha, 2015). Southeast Asian refugees who experi
enced racial discrimination reported high rates of depression (Noh, Beiser, Kaspar,
Hou, & Rummens, 1999).
Implications
A therapist must assess the effects of possible environmental factors, such
as racism, on mental health issues in Asian Americans and help ensure that
clients not internalize issues based on discriminatory practices. Instead, the
focus should be on how to deal with racism and on possible efforts to change
the environment. If a problem occurs in school, the therapist can help assess
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SPECIFIC CHALLENGES
517
the school’s social receptivity to Asian students. The same can be done with
discriminatory practices at the client’s place of employment. Intervention
may have to occur at a systems level, with the therapist serving in the role of
advocate for the client.
IMPLICATIONS FOR CLINICAL PRACTICE
[A] one-size-fits-all approach to clinical work with Asian Americans is poten
tially problematic. Instead, it is important for clinicians to identify within-group
differences among their Asian American clients based on their mental illness,
lay beliefs, and level of enculturation. (Wong et al., 2010, p. 328)
There is a range of acceptable practices in working with Asian American clients.
Qualities such as attitudinal similarity between the counselor and the Asian Ameri
can client and agreement on the cause and treatment of a disorder are more import
ant than racial match in promoting counselor credibility and a strong therapeutic
alliance (Meyer, Zane, & Cho, 2011). Asian Americans view counselors who demon
strate multicultural competence by addressing the cultural beliefs of clients as more
competent (Wang & Kim, 2010). Helping Asian American clients formulate culturally
acceptable strategies can improve their problem-solving abilities and facilitate the
development of skills for successful interactions within the larger society, including
balancing conflicting values. Many of the counseling skills learned in current mental
health programs, such as cognitive behavioral therapies, can be effective, especially
if modifications are made for less acculturated clients (W.-Y. Lau, Chan, Li, & Au, 2010).
Considerations in working with Asian American clients include the following:
1. Be aware of cultural differences between the therapist and the client in the
areas of counseling, appropriate goals, and process. Use strategies appropriate
to the collectivistic, hierarchical, and patriarchal orientation of Asian Americans,
when needed.
2. Build rapport by discussing confidentiality and explaining the client role, includ
ing the process of co-constructing the problem definition and solutions.
3. Identify and incorporate the client’s beliefs about the etiology and appropriate
treatment regarding the disorder.
4. Assess not just from an individual perspective but include family, community,
and societal influences on the problem. Obtain the worldview, degree of accul
turation, and ethnic identity of the Asian American client.
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518
COUNSELING THE CULTURALLY DIVERSE
5. Conduct a positive assets search. What strengths, skills, problem-solving abil
ities, and social supports are available to the individual or family? How have
problems been successfully solved in the past?
6. Consider or reframe the problem, when possible, as one involving issues of cul
ture conflict or acculturation.
7. Determine whether somatic complaints are involved, and assess their influence
on mood and relationships. Discuss somatic as well as psychological issues.
8. Take an active role, but allow Asian Americans to choose and evaluate sug
gested interventions. Asian Americans may prefer an immediate resolution to a
problem rather than in-depth exploration.
9. Use problem-focused, time-limited approaches that have been modified to
incorporate possible cultural factors.
10. Self-disclosure regarding strategies the counselor has used in the past to solve
problems similar to those faced by the client can be helpful.
11. With family therapy, the therapist should be aware that Western-based theo
ries and techniques may not be appropriate for Asian families. Determine the
structure and communication patterns among the members. It may be helpful
to address the father first and to initially have statements by family members
directed to the therapist. Focus on positive aspects of parenting, such as model
ing and teaching.
12. In couples counseling, assess for societal or acculturation conflicts, and deter
mine the couple’s perspective on what an improved relationship would look
like. Problems often occur when there are differences in acculturation between
the partners. Determine the ways that caring, support, or affection is shown,
including providing for economic needs.
13. With Asian children and adolescents, common problems involve acculturation
conflicts with parents, feeling guilty or stressed over poor academic perfor
mance, negative self-image or identity issues, and struggles between interde
pendence and independence.
14. Consider the need to act as an advocate or to engage in systems-level interven
tion in cases of institutional racism or discrimination.
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REFERENCES
519
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SUMMARY
Asian Americans/Pacific Islanders are nearly 6% of the population, but are com
posed of 40 distinct subgroups, each with its own language, religion, and customs.
The counselor should not assume that they are all the same. Asian Americans are
often seen as a “model minority”; the myth has masked the historical and continu
ing prejudice and discrimination directed toward them. Counselors working with
Asian American/Pacific Islanders must be cognizant of major cultural differences
such as collectivism, hierarchical relationships, parenting styles, emotionality, holis
tic orientation, and academic/occupational goal orientations that contrast with
EuroAmerican characteristics. A failure to acknowledge these differences may lead
to inappropriate and ineffective treatments. Further, it is important to understand
and work with the strengths of the group, and be knowledgeable about racial
identity development, acculturation conflicts, and the different expectations Asian
Americans may have of counseling. Fourteen clinical implications for counselor
practice are identified.
GLOSSARY TERMS
Acculturation
Hierarchical relationships
Assimilation
Integration/biculturalism
Co-construction
Model minority
Collectivistic orientation
Saving face
Emotionality
Somatic complaints
REFERENCES
Ahn, A. J., Kim, B.S.K., & Park, Y. S. (2009).
Asian cultural values gap, cognitive flexibility,
coping strategies, and parent-child conflicts
among Korean Americans. Asian American
Journal of Psychology, S(1), 1, 29–44.
Aronowitz, N. W. (2014). Proud heritage: Mentors
teach Native students about their pasts. Retrieved
from http://www.nbcnews.com/news/education
/proud-heritage-mentors-teach-native-students
-about-their-pasts-n184271
Atkinson, D. R., Kim, B.S.K., & Caldwell,
R. (1998). Ratings of helper roles by multicultural psychologists and Asian American stu
dents: Initial support for the three-dimensional
model of multicultural counseling. Journal of
Counseling Psychology, 45, 414–423.
Blair, S. L., & Qian, Z. (1998). Family and Asian
students’ educational performance. Journal of
Family Issues, 19, 355–374.
EBSCO : eBook Collection (EBSCOhost) - printed on 4/7/2019 3:08 PM via TOURO COLLEGE - LOS ANGELES
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Copyright @ 2016. Wiley.
All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law.
520
COUNSELING THE CULTURALLY DIVERSE
Brenner, A. D., & Kim, S. Y. (2009). Experiences
of discrimination among Chinese American
adolescents and the consequences for socio
emotional and academic development. Devel
opmental Psychology, 45, 1682–1694.
Buki, L. P., Ma, T.-C., Strom, R. D., & Strom,
S. K. (2003). Chinese immigrant mothers of
adolescents: Self-perceptions of acculturation
effects on parenting. Cultural Diversity and
Ethnic Minority Psychology, 9, 127–140.
Chang, H.-L., Chen, S.-P., & Cha, C. H. (2015).
Perceived discrimination, intergenerational
family conflicts, and depressive symptoms in
foreign-born and U.S.-born Asian American
emerging adults. Asian American Journal of Psy
chology, 6, 107–116.
Chang, T.-F., Han, E.-J., Lee, J.-S., & Qin, D.
B. (2015). Korean American adolescent eth
nic-identity pride and psychological adjust
ment: Moderating effects of parental support
and school environment. Asian American Jour
nal of Psychology, 6, 190–199.
Chen, E. W.-C. (2009). Chinese Americans. In
E. W.-C. Chen and G. J. Yoo, Encyclopedia of
Asian American issues today (vol. 1, pp. 222–
223). Westport, CT: Greenwood.
Chen, P.-H. (2009). A counseling model for
Self-relation coordination for Chinese clients
with interpersonal conflicts. Counseling Psy
chologist, 37, 987–1009.
Chen, S. W.-H., & Davenport, D. S. (2005).
Cognitive-behavioral therapy with Chinese
American clients: Cautions and modifications.
Psychotherapy: Theory, Research, Practice, Train
ing, 42, 101–110.
Choi, Y. H. (1999, September 7). Commentary:
Asian values meet Western realities. Los Angeles
Times, p. 7.
Corrigan, M. (2011). Tiger mothers: Raising chil
dren the Chinese way. Retrieved from http://
www.npr.org/2011/01/11/132833376/tiger
-mothers-raising-children
Eaton, M. J., & Dembo, M. H. (1997). Dif
ferences in the motivational beliefs of Asian
Americans. Journal of Educational Psychology,
89, 433–440.
Fuligni, A. J., Burton, L., Marshall, S., PerezFebles, A., Yarrington, J., Kirsh, L. B., &
Merriwether-DeVries, C. (1999). Attitudes
toward family obligations among American
adolescents with Asian, Latin American, and
European backgrounds. Child Development,
70, 1030–1044.
Grover, S., & Ghosh, A. (2014). Somatic symp
tom and related disorders in Asians and Asian
Americans. Asian Journal of Psychiatry, 7, 77–79.
Huang, L. N. (1994). An integrative approach
to clinical assessment and intervention with
Asian-American adolescents. Journal of Clinical
Child Psychology, 23, 21–31.
Hwang, W.-C., & Goto, S. (2009). The impact of
perceived racial discrimination on the mental
health of Asian American and Latino college
students. Asian American Journal of Psychology,
S(1), 15–28.
Hwang, W.-C., Woods, J. J., & Fujimoto, K.
(2010). Acculturative family distancing (AFD)
and depression in Chinese American families.
Journal of Consulting and Clinical Psychology,
78, 655–667.
Jose, P. E., Huntsinger, P. R., & Liaw, L. (2004).
Parental values and practices relevant to young
children’s social development in Taiwan and
the United States. Journal of Cross-Cultural Psy
chology, 31, 677–702.
Kelly, M., & Tseng, H. (1992). Cultural dif
ferences in childrearing: A comparison of
immigrant Chinese and Caucasian American
mothers. Journal of Cross-Cultural Psychology,
23, 444–455.
Kim, B.S.K. (2007). Adherence to Asian and
European American cultural values and atti
tudes toward seeking professional psycholog
ical help among Asian American students.
Journal of Counseling Psychology, 54, 474–480.
EBSCO : eBook Collection (EBSCOhost) - printed on 4/7/2019 3:08 PM via TOURO COLLEGE - LOS ANGELES
AN: 1110445 ; Sue, Derald Wing, Sue, David.; Counseling the Culturally Diverse : Theory and Practice
Account: ns011983.main.ehost
REFERENCES
Copyright @ 2016. Wiley.
All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law.
Kim, B.S.K. (2011). Counseling Asian Americans.
Belmont, CA: Cengage.
Kleinman, A. (2004). Culture and depression. New
England Journal of Medicine, 351, 951–953.
Larson, J. L. (2009). 2009 national survey: Pub
lic attitudes toward Chinese and Asian Amer
icans. Retrieved from http://committee100
.typepad.com/committee_of_100_newslett
/survey_pressclips
Lau, A. S. (2012). Reflections on adapting parent
training for Chinese immigrants: Blind alleys,
thoroughfares, and test drives. In G. Bernal &
M. M. Domenech Rodriguez (Eds.), Cultural
adaptations: Tools for evidence-based practice with
diverse populations (pp. 133–156). Washington,
DC: American Psychological Association.
Lau, A. S., Fung, J. J., & Yung, V. (2010). Group
parent training with immigrant Chinese fam
ilies: Enhancing engagement and augmenting
skills development. Journal of Clinical Psychol
ogy: In Session, 66, 880–894.
Lau, J. S., Fung, J., Wang, S.-W., & Kang, S.-M.
(2009). Explaining elevated social anxiety
among Asian Americans: Emotional attunement
and a cultural double bind. Cultural Diversity
and Ethnic Minority Psychology, 15, 77–85.
Lau, W.-Y., Chan, C. K.-Y., Li, J. C.-H., & Au, T.
K. F. (2010). Effectiveness of group cognitivebehavioral treatment for childhood anxiety in
community clinics. Behaviour Research and
Therapy, 48, 1067–1077.
Lee, C.-R. (1995). Native speaker. New York, NY:
Berkley.
Lee, R. M., Choe, J., Kim, G., & Ngo, V. (2000).
Construction of the Asian American Family
Conflicts Scale. Journal of Counseling Psychol
ogy, 47, 211–222.
Lee, R. M., Su, J., & Yoshida, E. (2005). Coping
with intergenerational family conflict among
Asian American college students. Journal of
Counseling Psychology, 52, 389–399.
521
Lim, B. N. (2014). I am not a model minority.
Retrieved from http://www.thecrimson.com
/article/2014/2/13/harvard-model-minority/
Lo, H.-W. (2010). My racial identity development
and supervision: A self-reflection. Training and
Education in Professional Psychology, 4, 26–28.
Lorenzo, M. K., Pakiz, B., Reinherz, H. Z., &
Frost, A. (1995). Emotional and behavioral
problems of Asian American adolescents: A
comparative study. Child and Adolescent Social
Work Journal, 12, 197–212.
Louie, S. (2014a). Asian shame and honor:
A cultural conundrum and case study.
Retrieved from https://www.psychologytoday
.com/blog/minority-report/201406/asian
-shame-and-honor
Louie, S. (2014b). Honor and suicide.
Retrieved from https://www.psychologytoday
.com/blog/minority-report/201406/asian
-honor-and-suicide
Lucas, M. S., & Berkel, L. A. (2005). Counseling
needs of students who seek help at a university
counseling center: A closer look at gender and
multicultural issues. Journal of College Student
Development, 46, 251–266.
Mallinckrodt, B., Shigeoka, S., & Suzuki, L. A.
(2005). Asian and Pacific Island American stu
dents’ acculturation and etiology beliefs about
typical counseling presenting problems. Cul
tural Diversity and Ethnic Minority Psychology,
11, 227–238.
Meyer, O., Zane, N., & Cho, Y. I. (2011). Under
standing the psychological processes of the
racial match effect in Asian Americans. Jour
nal of Counseling Psychology, 58, 335–345.
Retrieved from http://www.ncbi.nlm.nih.gov
/pubmed/21574698
Mintz, L. B., & Kashubeck, S. (1999). Body image
and disordered eating among Asian American
and Caucasian college students: An examina
tion of race and gender differences. Psychology
of Women Quarterly, 23, 781–796.
EBSCO : eBook Collection (EBSCOhost) - printed on 4/7/2019 3:08 PM via TOURO COLLEGE - LOS ANGELES
AN: 1110445 ; Sue, Derald Wing, Sue, David.; Counseling the Culturally Diverse : Theory and Practice
Account: ns011983.main.ehost
Copyright @ 2016. Wiley.
All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law.
522
COUNSELING THE CULTURALLY DIVERSE
Nadal, K. L., Escobar, K. M., Prado, G., David,
E.J.R., & Haynes, K. (2012). Racial microaggressions and the Filipino American expe
rience: Recommendations for counseling and
development. Journal of Multicultural Counsel
ing and Development, 40, 156–173.
Nguyen, S. D. (1985). Mental health services for
refugees and immigrants in Canada. In T. C.
Owen (Ed.), Southeast Asian mental health:
Treatment, prevention, services, training, and
research (pp. 261–282). Washington, DC:
National Institute of Mental Health.
Noh, S., Beiser, M., Kaspar, V., Hou, F., & Rummens, J. (1999). Perceived racial discrimi
nation, depression, and coping: A study of
Southeast Asian refugees in Canada. Journal of
Health and Social Behavior, 40, 193–207.
O’Reilly, J. P., Tokuno, K. A., & Ebata, A. T.
(1986). Cultural differences between Amer
icans of Japanese and European ancestry in
parental valuing of social competence. Journal
of Comparative Family Studies, 17, 87–97.
Paiva, N. D. (2008). South Asian parents’ con
structions of praising their children. Clinical
Child Psychology and Psychiatry, 13, 191–207.
Pew Research Center. (2013). The rise of
Asian Americans. Retrieved from http://
www/pewsocialtrends.org/2012/06/the-rise
-of-asian-americans/2/
Ramakrishnan, K., & Ahmad, F. Z. (2014).
Income and poverty. Retrieved from https://cdn
.americanprogress.org/wp-content/.../AAPI
-IncomePoverty.pdf.
Russell, S. T., Crockett, L. J., & Chao, R. (Eds.)
(2010). Asian American parenting and par
ent-adolescent relationships. New York, NY:
Springer.
Sirikantraporn, S. (2013). Biculturalism as a pro
tective factor: An exploratory study on resil
ience and the bicultural level of acculturation
among Southeast Asian American youth who
have witnessed domestic violence. Asian Amer
ican Journal of Psychology, 4, 109–115.
Son, E., & Ellis, M. V. (2013). A cross-cultural
comparison of clinical supervision in South
Korea and the United States. Psychotherapy, 50,
189–205.
Srivastava, S. (2009). Nobody’s model minority.
Retrieved from http://theroot.com/Home
/Nobody’sModelMinority
Suyemoto, K. L., Day, S. C., & Schwartz, S.
(2015). Exploring effects of social justice youth
programming on racial and ethnic identities
and activism for Asian American youth. Asian
American Journal of Psychology, 6, 125–135.
Tsuda, T. (2014). “I’m American, not Japanese!”:
The struggle for racial citizenship among latergeneration Japanese Americans. Ethnic and
Racial Studies, 37, 405–424.
Tsui, P., & Schultz, G. L. (1985). Failure of rap
port: When psychotherapeutic engagement
fails in the treatment of Asian clients. American
Journal of Orthopsychiatry, 55, 561–569.
U.S. Census Bureau. (2010). Facts for features:
Asian American heritage month. Retrieved from
http://www.census.gov/newsroom/releases
/archives/facts_for_features_special_editions
/cb10-ff07.html
U.S. Census Bureau. (2011a). Age and sex composi
tion: 2010. Retrieved from http://www.census
.gov/prod/cen2010/briefs/c2010br-03.pdf
U.S. Census Bureau. (2011b). Hispanic heritage
month. Retrieved from http://www.census
.gov/newsroom/releases/archives/facts_for
_features_special_editions/cb11-ff18.html
U.S. Census Bureau. (2015). People quickfacts.
Retrieved from http://quickfacts.census.gov/qfd
/states/00000.html
Vakalahi, H.F.O. (2009). Pacific Islander Amer
ican students: Caught between a rock and a
hard place? Children and Youth Services Review,
31, 1258–1263.
Wang, S., & Kim, B.S.K. (2010). Therapist mul
ticultural competence, Asian American partic
ipants’ cultural values, and counseling process.
Journal of Counseling Psychology, 57, 394–401.
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REFERENCES
Wong, Y. J., Tran, K. K., Kim, S.-H., Kerne,
V.V.H., & Calfa, N. A. (2010). Asian
Americans’ lay beliefs about depression and
professional help seeking. Journal of Clinical
Psychology, 66, 317–332.
523
Zane, N., & Ku, H. (2014). Effects of ethnic
match, gender match, acculturation, cultural
identity, and face concern on self-disclosure
in counseling for Asian Americans. Asian
American Journal of Psychology, 5, 66–74.
Ying, Y.-W., Coombs, M., & Lee, P. A. (1999).
Family intergenerational relationship of Asian
American adolescents. Cultural Diversity and
Ethnic Minority Psychology, 5, 350–363.
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AN: 1110445 ; Sue, Derald Wing, Sue, David.; Counseling the Culturally Diverse : Theory and Practice
Account: ns011983.main.ehost
Copyright @ 2016. Wiley.
All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law.
EBSCO : eBook Collection (EBSCOhost) - printed on 4/7/2019 3:08 PM via TOURO COLLEGE - LOS ANGELES
AN: 1110445 ; Sue, Derald Wing, Sue, David.; Counseling the Culturally Diverse : Theory and Practice
Account: ns011983.main.ehost
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