HaysErford_3e_CH11_PPT.PPTX

Chapter 11
Developing Multicultural Counseling Competence: A Systems Approach
Individuals and Families of
Asian Descent
Third Edition

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1

Learning Objectives
After reading Chapter 11, students will be able to:
Understand the historical factors affecting Asian American culture.
Identify forms of discrimination and stereotypes which affect Asian Americans.
Understand the heterogeneity within the Asian American culture.
Understand the beliefs and values of the Asian American culture.
Identify gender roles within the Asian American culture.
Understand the components of interpersonal relationships as well as the cultural expectations for intimacy and marriage of Asian Americans.
Understand the importance of religion and education within the Asian culture.
Identify the overarching ideas of how Asian Americans deal with death and dying.
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Learning Objectives
Understand individual differences and identities with regard to immigration, enculturation, acculturation, ethnicity, race, gender roles, sexuality and sexual identity.
Identify general mental health issues of people of Asian descent by exploring various psychological disorders among Asian Americans.
Understand how Asian Americans seek help and how they cope.
Identify and explore guidelines for counseling clients of Asian descent by examining the need for counselor self-assessment and the process of counseling Asian Americans (e.g., conceptualization of the problem, interventions).
Understand how outreach and non-clinical visibility, as well as social advocacy plays a part in the counseling process for Asian Americans.
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Individuals and Families of Asian Descent
Asian Americans represent three broad yet distinct groups:
East Asians from China, Taiwan, Japan, Philippines, and Korea
South Asians from India, Pakistan, Bangladesh, Sri Lanka, Nepal, Bhutan, and the Maldives
Southeast Asians from Vietnam, Laos, Hmong, and Cambodia
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Individuals and Families of Asian Descent
At 5.2% of the population, the 16.1 million individuals who describe themselves as Asian American have rapidly emerged onto the racial landscape of the U.S.
With a growth rate of 43.3% between 2000 and 2010, the Asian American community has been characterized as one of the fastest growing racial and ethnic communities.
The U.S. Census Bureau estimates that by 2050, this diverse Asian American community will increase by over 200% and constitute 8% of the U.S. population.
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Asian American History
The large-scale arrival of Chinese laborers on the Hawaiian sugar plantations and the gold mines of California in the mid-1800s was the start of immigration among Asian ethnic groups.
Chinatowns began to develop because Chinese Americans were restricted from living among Whites, owning land, buying property, intermarrying with Whites, or obtaining an education.
Anti-Asian violence was common for early Asian American immigrants.
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Asian American History
Institutional and legislative forms of discrimination were also enacted against Asian American communities, including:
The Chinese Exclusion Act of 1882: The first ethnic-specific ban of its kind
The Gentleman’s Agreement of 1907: Restricted Japanese immigration
The Immigration Act of 1917: Restricted Asian Indian immigration
The Tydings-McDuffie Act of 1934: Restricted Filipino immigration
The 1942 incarceration of 120,000 Japanese Americans in remote internment camps
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Asian American History
The Immigration and Nationality Act of 1965 based immigration on family reunification rather than national origins quotas, which resulted in an 800% increase in the number of Asian immigrants since 1970.
In contrast to this influx of voluntary immigrants, Southeast Asian refugees after the 1975 fall of South Vietnam were forced to flee their countries.
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Contemporary Forms of Discrimination and Stereotypes
Asian Americans continue to encounter contemporary forms of institutional racism, including:
“English-only” language initiatives
Income-to-education disparities
Glass ceiling effects in career advancement
Asian Americans also continue to experience individual racism. Examples include:
Differential treatment
Verbal insults and racial slurs
Physical harassment
Vandalism
Homicide
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Contemporary Forms of Discrimination and Stereotypes
Of particular relevance to contemporary Asian Americans are the stereotypes of the “perpetual foreigner” and the “model minority.”
Despite the repeal of anti-naturalization laws that explicitly prohibited them from becoming citizens, Asian Americans continue to be implicitly regarded as “illegitimate Americans,” regardless of their nativity or citizenship.
The model minority myth has been used to describe and elevate the status of Asian Americans as a model community that has “overcome” its minority status, and it can have deleterious effects on Asian Americans’ physical and psychological well-being.
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Asian American Heterogeneity
The aggregation of Asian Americans as a racial group obscures the ethnic heterogeneity of this community.
There are approximately 43 distinct Asian ethnic groups from 20 different countries of origin.
Asian Americans are also diverse in terms of their immigration histories.
Within-group ethnic differences in immigration should be noted.
Immigration patterns may have significant implications for clients’ understanding of and adaptation to U.S. cultural norms.
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Asian American Culture and Values
Although there is much diversity, Asian Americans are influenced by some common values, ideologies, and philosophies that guide their lives and perspectives.
The extent to which Asian Americans adhere to these values is influenced by their generational status, immigration histories, and acculturation levels.
To prevent making generalizations, counselors are encouraged to increase their knowledge of the complexities of and distinctions within the Asian American culture.
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Family
Family or kinship refers to an extended network of relationships that encompasses several households.
Filial piety is an abstract concept, which prescribes the way children need to show respect and obedience toward their parents, elders, and ancestors.
It is common for adult children to reside with their parents until and even after marriage and for married sons to take care of their parents in their old age.
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Family
Parenting tends to be authoritarian and directive, and the family structure is typically patriarchal.
Children are taught to be responsible for their actions and to control their emotions, as well as to respect elders.
Actions that benefit the family are praised whereas guilt-inducing techniques (e.g., withdrawing familial support) are often used as a means of enforcing discipline and maintaining family cohesion.
Counselors should consider family dynamics and other related factors, such as individual and family immigration history, adaptation experiences, cultural values, and generational differences due to differences in acculturation experience.
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Gender Roles
Gender roles and responsibilities are clearly prescribed and based on one’s authority and status in the family and social hierarchy.
It is important to note that within-group differences exist:
Japanese Americans tend to be more acculturated and hence more egalitarian in their roles.
Filipino Americans also tend to be more egalitarian.
Chinese Americans, Koreans, and Southeast Asians tend to be more patriarchal and traditional in orientation.
South Asians have been noted to be traditional in their homes but contemporary in relation to education- and achievement-related issues.
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Interpersonal Relationships
Among Asian Americans, maintaining harmony governs interpersonal relationships.
Being nondirective, nonconfrontational, and silent are considered virtues.
Moderation in behaviors is valued through self-restraint and self-control.
Displaying strong emotions is often seen as a sign of immaturity.
Humility in deeds and actions is seen as maintaining respect and dignity in relationships.
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Intimacy and Marriage
Asian American youth are traditionally not encouraged to date.
Parents and extended family play an important role in choosing a mate for their children through social networks.
Arranged or semi-arranged marriages are a common practice among South Asian communities, but marriage based on love and mutual compatibility has increasingly become a norm for Asian American youth.
Asian Americans traditionally tend to be modest regarding their sexuality and nondemonstrative in their sexual and physical affection.
Divorce and interracial marriages have traditionally not been a common practice among Asian Americans, although interracial marriages are increasing.
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Education
Academic achievement and a successful career are highly valued and indicative of a good family upbringing.
There is pressure to spend time studying at the expense of other curricular activities and pressure to obtain certain jobs (e.g., science related or technical).
In response to perceived restrictions and limitations due to discrimination, Asian Americans place a higher value on education as the most viable means of upward mobility, a concept they refer to as relative functionalism.
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Religion
A majority of Asian communities believe in fate, rebirth, and an afterlife.
Pain and pleasure are seen as a natural part of one’s existence.
These religious philosophies influence perspectives on life, health, and illness.
In many of these communities, places of worship (e.g., churches, mosques, temples, monasteries) and religious figures such as the priest or minister (Christianity), the mullah/Imam (Islam), pundit (Hinduism), or monk (Buddhism) may be key sources of support during times of difficulties.
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Religion
Depending on the geographical region, different religious teachings serve as important spiritual philosophies guiding Asian American lives.
East Asian Americans: Confucianism, Buddhism, and Christianity
Filipinos: Catholicism
Japanese Americans: Buddhism, Christianity, and Shintoism
South Asia: primarily Hinduism
India and other regions of South Asia: Islam, Sikhism, Jainism, Zoroastrianism, Ba’hai faith, and Judaism
Cambodians and Laotians: Hinduism and Buddhism
Vietnamese: Buddhism and Catholicism
The Mien and Hmong: believe in supernatural powers and are animistic
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Death and Dying
Death is a communal affair among several Asian groups.
Burials and cremation ceremonies are traditionally performed by the males in the family, and elders are often consulted in performing rites.
The Hmong believe that proper burial and ancestral worship influence the health, safety, and prosperity of the family.
Buddhists believe that proper burial rituals and state of the mind of the dying person influence the rebirth process.
For Hindus, cremations and other death rituals are designed to assist with rebirth and release the soul from its earthly existence.
For Muslims, burials are crucial to the Islamic belief in the physical resurrection of the dead.
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Individual Differences and Identities
There are multiple ways in which aspects of diversity (e.g., immigration, ethnicity, race, gender) shape the socialization processes, identity development, and interactions for Asian Americans.
Asian American identities are multidimensional and must be examined through the interrelated axes of the different contexts (e.g., race, gender, and sexual orientation).
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Immigration, Enculturation, and Acculturation
Factors that mediate Asian American adaptation to U.S. society include:
The nature and reason for immigration
The age at immigration
Language abilities
Past and present exposure to Western cultures
Immigration status
Socioeconomic status
Professional status
Ethnic pride
The length of stay in the U.S.
The emigrational status of an individual is an important determinant of the nature of transition and adjustment that individuals make in moving to a new environment.
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Immigration, Enculturation, and Acculturation
Immigrants are foreign-born individuals who leave their countries on a voluntary basis.
They moved to a new country for economic opportunities and upward mobility, and they are free to return to or visit their countries without legal restrictions.
Immigrants may come to the U.S. for short periods of time or on a permanent basis.
Refugees, although foreign born, are involuntarily displaced from their countries.
They are often forced to leave their countries of origin due to political unrest, human rights violations, or other chaotic situations
They are in exile from their own lands and are unable to return.
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Immigration, Enculturation, and Acculturation
To facilitate success, Asian Americans have been noted to selectively adapt to certain U.S. cultural norms (e.g., English proficiency, career goals, dress) while holding onto fundamental ethnic cultural values related to family relations, religion, and intimate relations.
Although Asian Americans might engage in U.S.-based activities, they may not fully identify with the American culture.
Asian Americans who are born in the U.S. may have a stronger identification with the American culture first and Asian culture second.
Others may be both strongly acculturated to American culture and strongly identified with Asian culture.
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Ethnicity and Race
Because of a bicultural influence, Asian Americans internalize two cultures that inform and influence their lives—the Asian identity and the American identity.
Ethnic identity may function differently for foreign-born Asians versus U.S.-born Asian Americans.

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Ethnicity and Race
Cultural frame switching refers to the notion that different aspects of identity may be activated based on different contexts.
Despite a long history of racism and discrimination, there are varying views of acceptance from within and outside this community.
Factors that mask the negative effects of discrimination on Asian Americans include:
The model minority myth
The tendency to dichotomize racism as a Black-White issue
The lack of racial socialization and a language to speak to these issues among new immigrants
Related racial politics of success and economics
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Ethnicity and Race
There has been a greater attention to and awareness of racism within this community due to discrimination and reports of increased anti-Asian sentiment since 9/11.
Asian Americans experience racial microaggressions in the form of microassaults, microinsults, and microinvalidations.
The experiences of racial discrimination are internalized by Asian Americans.
Thus, the intersections of ethnic and racial identities must be considered when working with this population.
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Gender Roles
Stereotyped images of Asian women as being subservient, passive, innocent, and as mail-order brides has led to sexual exploitation and objectification of these women.
Asian men are often stereotyped as being nerdy or geeky, feminine, industrious, passive, and asexual.
Men and women must negotiate competing cultural representations of masculinity and femininity as they manage their gender identity.
Immigration has created role reversals for some Asian immigrants, which significantly influences their family roles and expectations.
Difficulties in occupational mobility for some foreign-born Asian men have led more women to work outside the family.
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Sexuality and Sexual Identity
Historically, Asian cultures have depicted their attitudes and openness to sexual issues through the arts, literature, religion, history, and philosophy, with sexual themes covering a range of orientations.
However, Asian cultural norms have become more restrictive and place a strong emphasis on silence surrounding issues of sexuality.
Asian Americans perceive homosexuality as a Western concept, and it has been seen as a “White disease.”
As Asian American sexual minorities develop their identity, pressures related to marriage and the fear of familial rejection may be major hindrances in the ownership of their identity and the coming-out process.
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General Mental Health Issues of Individuals of Asian Descent
Research on counseling Asian Americans has generally used two approaches:
Epidemiological studies that attempt to be representative of a particular population at large.
Small-scale studies that often use smaller convenience samples.
Research has been hampered by relatively small samples of Asian Americans and the aggregation of Asian Americans across ethnic groups.
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General Mental Health Issues of Individuals of Asian Descent
A few epidemiological studies such as the Chinese American Psychiatric Epidemiological Study (CAPES) and the Filipino American Community Epidemiological Study (FACES) have provided valuable insights.
The National Latino and Asian American Study (NLAAS) is the most comprehensive study of Latino and Asian American mental health thus far.
Findings from these studies provide insight on racism and its relationship to psychological distress, including:
Depression
PTSD
Domestic violence
Anxiety
Schizophrenia
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General Mental Health Issues of Individuals of Asian Descent
Racism has an adverse impact on mental health, health, and health-related behaviors, including:
Self-esteem
Depression
Race-related stress
Drug use
Body image
HIV risk behaviors
PTSD
Chronic health concerns
Perceived discrimination is also associated with an increase in suicidal attempts and ideation, an increased likelihood of a mental disorder, and chronic health conditions.
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General Mental Health Issues of Individuals of Asian Descent
In contrast to earlier studies, a meta-analysis has indicated that depression rates among Asian Americans may be higher than that of the general population.
Various studies with Asian Americans provide conflicting results, and within-group differences are vast regarding prevalence of depression.
Immigration appears to be an important factor for mental health.
For U.S.–born Chinese Americans, lifetime prevalence rates of depressive disorder and suicidal ideation were much higher compared with China-born immigrants.
Individuals who immigrated as children were more likely to have psychiatric disorders than individuals who immigrated later in life.
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General Mental Health Issues of Individuals of Asian Descent
Pre-migration traumas, particularly among Southeast Asian refugees, have been consistently associated with the incidence of PTSD, suicide, and depression.
The effects of trauma can be multigenerational and persist over time.
A study found that two decades after resettlement in the United States, 62% of the Cambodian refugee participants continued to exhibit PTSD symptoms.
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General Mental Health Issues of Individuals of Asian Descent
Efforts at determining the prevalence of domestic violence among Asian Americans have been hampered by limited research, particularly in terms of epidemiological samples.
The NLAAS found relatively lower rates of intimate partner violence (IPV) among Asian American men and women compared to national rates.
However, the Asian and Pacific Islander Institute on Domestic Violence indicated higher rates of IPV compared to national rates.
Community-based studies of domestic violence among Asian American women have found rates ranging from 24% to 60% being victims.
Rates among Asian Americans may be underreported due to cultural values around self-disclosure.

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General Mental Health Issues of Individuals of Asian Descent
Fewer studies have been conducted on the prevalence of anxiety disorders and schizophrenia with individuals of Asian descent.
Earlier research has been relatively consistent in suggesting that these disorders occur for individuals of Asian descent at rates lower than or similar to Whites.
However, more recent empirical studies have reported higher social anxiety among people of Asian heritage, compared to people of Western heritage.
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Help-Seeking and Coping
Help-seeking may be influenced by Asian values and worldviews.
Asian Americans underutilize mental health services.
Only 8.6% of Asian Americans with a psychological problem sought any form of professional help, compared to 17.9% of the general population.
U.S.-born Asian Americans are more likely to see a mental health provider than foreign-born Asian Americans.
Other research has shown that a small percentage of Asian Americans over utilize mental health services.
The more acculturated and the greater the English language proficiency, the higher likelihood of seeking mental health services.
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Help-Seeking and Coping
At the individual level, barriers to seeking professional help may include:
Lack of knowledge or exposure to Western mental health treatment
Misconceptions about professional counseling
Immigration history
Length of stay in the U.S.
Levels of acculturation
Gender
History of previous treatment
Limited language proficiency
Client-counselor ethnic matching
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Help-Seeking and Coping
At the sociocultural level, barriers to seeking mental health services may include:
Cultural values and views of mental health
The notion of shame or loss of face
Expression of distress
Stigmatization of persons with mental illness and mental health services use
Availability of alternative healing practices
At the structural level or institutional level, conflict between the values endorsed by the Western mental health systems and Asian values may be a major deterrent to seeking professional help.
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Help-Seeking and Coping
Perceived counselor credibility was strongly related to utilization of services.
Lack of culturally sensitive and competent counselors contributes to high dropout rates or reticence in seeking professional help.
Inaccurate evaluations or misdiagnoses due to cultural biases, different social norms, or culturally incongruent scales may create significant difficulties in perceived credibility among Asian Americans.
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Help-Seeking and Coping
Sites of resiliency represent those psychological and/or physical spaces that help Asian Americans cope.
Several sites of resiliency have been identified for the Asian American community, including:
Use of alternative forms of healing
Holistic emphasis on health and a spiritually guided life (themes of fatalism, karma, and religion)
Family and social community
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Guidelines for Counseling Clients of Asian Descent
Education about counseling and the utility of mental health services is very much needed among Asian Americans who may not be acculturated to Western conceptualizations of health care.
Counselors play an integral role in educating clients about the counseling process.
Multicultural competence begins when counselors do a self-assessment before they enter the session.
Counselors are encouraged to obtain training, attend workshops and presentations, and familiarize themselves with the literature on this community.
Counselors should reflect on their socialization experiences with Asian Americans, their assumptions and biases about this community, and the extent to which this may influence their work as counselors.
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Guidelines for Counseling Clients of Asian Descent
When treating Asian American clients, understanding how counseling and the counseling process may be conceptualized within a cultural context plays a significant role in providing culturally sensitive therapy.
Depending on their acculturation level, Asian Americans tend to be deferential to people in authority (e.g., the counselor), and counselors are seen as experts.
There may be a tendency on the part of some Asian Americans to expect a quick fix to the problem.
Talking about their issues conflicts with some Asian cultural values.
Developing a relationship is important in creating a trusting environment.
Types of counselor self-disclosures (e.g., strategies, intimate disclosures) can be helpful.
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Guidelines for Counseling Clients of Asian Descent
It is important to align the conceptualization of the problem to the multiple contexts in which individuals exist.
Counselors should assess the relative significance of various relationships, systems, and environments.
Counselors should recognize the psychological significance of immigration.
Exploring the negotiation between education and class, ethnic and racial identities, and gender and sexual identities is paramount so that counselors can understand potential pressures that Asian Americans experience.
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Guidelines for Counseling Clients of Asian Descent
Asian Americans may not openly express strong emotion.
They may not publicly disclose personal and family issues that may bring shame on their families.
Asian Americans typically prefer an authoritarian, directive, and structured approach to treatment.
Because of the significant role families play, family therapy might be an appropriate intervention.
To prevent stereotyping or overgeneralizing, it is essential to assess individual differences that exist within and across generations and ethnic groups.
Specific needs and adjustment issues of American-born Asians can be quite different from those of foreign-born Asians.
Voluntary Asian immigrants’ needs and adjustments can be different from nonvoluntary immigrants or refugees from Asia.
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Guidelines for Counseling Clients of Asian Descent
When working with a diverse Asian community, counselors should:
Develop a range of treatment modalities.
Assess the problem to determine if it is individual, systemic, environmental, or a combination of these.
Be sensitive to the cultural norm of placing a family’s needs before an individual’s needs.
Factor alternative healing approaches into treatment.
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Guidelines for Counseling Clients of Asian Descent
“Word of mouth” referrals play a significant role in Asian Americans seeking counseling.
Perceived expertness in a counselor is often a function of reputation, evidence of specialized training, and behavioral evidence of proficiency and competency.
Perceived trustworthiness includes factors of sincerity, openness, honesty, or lack of motivation for personal gain.
Counselor self-disclosure is intrinsic to developing trust.
Engaging in advocacy and outreach and maintaining visibility in the community is extremely important to develop credibility.
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