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in traditional Asian culture, the family unit is privileged over the needs of the individual. “The individual is seen as the sum of all the generations of his or her family” (Lee & Mock, 2005, p. 274). Further, “marriages are arranged by parents or grandparents to ensure family prosperity and propagation of the husband’s family line” (Lee & Mock, 2005, p. 274). Another important point to consider is “The primary relationship is more likely to be the parent-child dyad, rather than that of the husband-wife” (p. 274).

How does this worldview influence your approach to helping an Asian couple or family? Support your assertions with the professional literature reviewed this week in the course.

Please read the attached text to help answer the question properly. Must include at least 1 in text cite. No plagiarism Answer must be at least 250 words

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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. 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 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. 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 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. 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, 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. 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. 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 CHARACTERISTICS AND STRENGTHS 505 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. 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 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. 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 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. 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 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. 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 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. 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). 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 510 COUNSELING THE CULTURALLY DIVERSE 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. 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 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. 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. 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 512 COUNSELING THE CULTURALLY DIVERSE 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. 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 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. 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 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. 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 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. 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 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. 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 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. 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. 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. 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. 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 519 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. 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 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. 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. 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. 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. 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. 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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Running head: ASIAN CULTURE

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Asian Culture
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ASIAN CULTURE
Asian Culture

Cultural competence refers to the ability of understanding, communicating and interacting
with people of different cultures. It entails developing positive attitudes towards different cultures.
It is very crucial when it comes to psychology, and it helps to make a proper diagnosis of the
patient. A psychol...


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