Caucasian Therapist Lacked Competence to Help the Asian American Client Discussion
Topic 4 DQ 1 (Obj. 4.1) DQ 1
A twenty-six-year-old Asian American client participated in an outpatient mental health program. He attended the program daily. When the client met with older male Caucasian therapist, he was very polite and agreeable. The client would agree to the treatment goals, yet, when he returned for the monthly review, the client had made no progress on the goals. What do you think might explain this client’s engagement or lack of engagement from a cultural/ethnic perspective?
This discussion question is informed by the following CACREP Standard(s):
2.F.2.a. Multicultural and pluralistic characteristics within and among diverse groups nationally and internationally.
TEXTBOOKS
Jones-Smith, E. (2019). Culturally diverse counseling: Theory and practice. Thousand Oaks, CA: Sage Publications Inc. ISBN-13: 9781483388267
URL:
https://www.gcumedia.com/digital-resources/sage/2018/culturally-diverse-counseling_theory-and-practice_1e.php
DQ 4,1 RESPONSES
Nichole Gelabert
2 posts
Re: Topic 4 DQ 1 (Obj. 4.1)
One possible cultural reason for this client’s lack of engagement is believing in a collectivist orientation. In most Eastern cultures, which includes Asian Americans, the belief is that the welfare of the whole group is more important than that of an individual’s needs (Jones-Smith, 2019). If this client feels that his individual goals will not benefit his family or group, he may not be inclined to carry them out. Another possibility is he was forced to seek mental health services, and is doing so out of respect for the person who sent him, with no intention of shaming his family. In a study by Zubin DeVitre and David Pan (2020), they discuss Asian American aversions and reasons for seeking mental health services through enculturation (maintaining indigenous values) and acculturation (acquiring host culture’s values) identity. Their findings showed that participants valuing their cultural beliefs negatively affected their feelings towards seeking counseling help. To me, this demonstrates the importance of knowing your client’s cultural identity. Not only will they receive services appropriate to their values and beliefs, but we (counselors) know what resistances we may face. Maybe this client could become engaged in services if the counselor incorporates activities or skills that are familiar to what this client practices within his culture. This may include mediation, understanding that physical and mental health are connected, or finding a way to have the individual goals benefit the group.
Christy Johnson
2 posts
Re: Topic 4 DQ 1 (Obj. 4.1)
According to Jones-Smith (2019) there are several reasons this client seems to be agreeable but is making no progress. One explanation may be that this client has recently immigrated to the United States and has not embraced Western-focused mental health practices. The counselor may have mistaken their clients “head nodding, smiles, and apparent verbal assent as clear indications of their understanding and agreement” (Jones-Smith, 2019, p. 300), when in fact, the client was trying to express their lack of understanding or shame about treatment goals.
Kim and Park (2015) describe Asian cultures communication style as indirect and high context, which means they are less vocal, more submissive, and try to communicate in a way that does not cause contention or harm to the other person. This client may not agree with the goals that have been put in place, but is trying to keep the peace by not sharing this with his counselor to avoid negativity and being a burden. Another reason for this client’s lack of engagement may because he is highly enculturated to his Asian roots and feeling like he needs to defend his families honor by not actively participating in the treatment plan (Jones-Smith, 2019). Jones-Smith (2019) denotes “…cultural prescriptions against revealing family secrets…therapists’ inability to design culturally appropriate forms of treatment” (Leong, 1996, as cited by Jones-Smith, 2019, p. 303) as a possible issue for a lack of engagement in the therapeutic process.
If the counselor is being very direct about the client not making progress towards his goals, the client may be trying to what Kim and Park (2015) call “maintaining face” (p. 270), which is described as “the individual’s sense of positive image in a social interaction” (Kim & Park, 2015, p. 270).
Rachael Herbison
2 posts
Re: Topic 4 DQ 1 (Obj. 4.1)
This client’s response may be a result of incorrect interaction from the counselor. A study by Fey & Roysircar (2004) indicates that there is a clear difference between White Americans and Asian Americans and responses to certain coping skills.
The counselor must find treatment that is culturally centered. In a study done by Yeh et al. (2006), Asian Americans who lost loved ones in the September 11, 2001 attacks used many coping strategies that focused on themselves as individuals, families and culture, as well as incorporating spiritual life as well. Though all or none of these may work for the client, it is vital that the counselor works with the client to determine a more appropriate approach, perhaps introducing one of these, or similar, methods.
The counselor needs to look at their practice and determine if they are using essential cross-cultural practices, such as were used in the Indochinese Mental Health Project: “counselor’s recognition of the several stages of crises; awareness of the impact of each stage on refugees, and nonjudgmental, nonauthoritarian, culturally appropriate crisis interventions (Weiss & Parish, 1989).” The counselor may be projecting cultural misunderstanding, interacting with the culture of and in this client (Jones-Smith, 2019).
Company: The of Montgomery County
Title: PROGRAM COORDINATOR
From 05/2021-Current
Responsibilities include • Hire/train and provide direct supervision to Residential Lead Staff and Direct Support Professionals. • Maintaining and/or completing monthly reports, fire safety records, staff and consumer records. • Ensuring quality services by monitoring program function through record reviews and other site documentation. • Ensuring compliance with all applicable state and agency guidelines. • Participating in the on-call supervisor rotation. • Act as liaison with county, day programs, families and doctors. • Attend meetings ( ISP, Monitoring, SIS, Staff meetings, etc.) as necessary for the home and individuals. • Provide ongoing staff oversight and monitoring by facilitating/completing staff trainings, 1:1 meetings, informal counseling, discipline and performance evaluations. • Monitor spending to ensure that expenditures are within budget for the homes and individuals. • Maintain medical records, and ensure and monitor proper programmatic data collection, via progress notes and charts, for all individuals. • Ensure scheduling and completion of timely medical appointments in accordance with State Regulations and medical needs of the individuals. • Working in conjunction with the lead staff to ensure that the staffing schedules reflect appropriate coverage and ratio’s for each home. • Other duties and responsibilities may be assigned.
RESPONSIBILITIES INCLUDE but are not limited to:
Objectively completes staff evaluations.
Monitors and ensures that residential budget is maintained.
Monitors and schedules required staff training, as well as relevant seminars, conferences and additional training.
Monitors and insures accurate “in house" documentation.
Participates in Circle(s) of Support for personal futures planning.
Monitors house and vehicles maintenance.
Ensures the accuracy of the disbursement and documentation of individual finances, as needed.
Monitors health and medical needs of individuals and audits medication administration.
Builds a support network between the individuals and community members.
Monitors the documentation of the individual’s progress for support people including family, staff, employment specialist, case manager and other professionals, as necessary.
Ensures consistent service delivery which connects work, home, and recreational needs.
Serves as an active member of each person’s interdisciplinary team, to include involvement in Individual Habilitation Plan development. Assists Residential Manager to coordinate the IDT meetings & the IHP/ELP.
Submit monthly written reports covering operational status, as well as individual progress and concerns to supervisor.
Attend conferences, seminars, and training relevant to the position.
Participates in all aspects of the individuals supported life and care. This includes but is not limited to cooking, cleaning, transporting, assisting with hygiene, etc.
Perform any and all duties requested of supervisor.
