workubg with imig. families

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This book is part of the Family Therapy and Counseling Series, edited by Jon Carlson.

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Library of Congress Cataloging-in-Publication Data

Working with immigrant families : a practical guide for counselors / edited byAdam Zagelbaum and Jon Carlson.

p. cm. -- (The family therapy and counseling series)Includes bibliographical references and index.ISBN 978-0-415-80061-7 (hardcover : alk. paper)1. Cross-cultural counseling--United States. 2. Immigrant

families--Counseling of--United States. I. Zagelbaum, Adam. II. Carlson, Jon.

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v

Contents

Series Editors Foreword ........................................................................... iiPreace ....................................................................................................... ix

Contritors ............................................................................................xiii

1 Orientation to Workin With Immirant Families .......................... 1ADAM ZAgELbAuM AND JON CARLSON

2 Teories o Accltration and Cltral Identit ............................. 21IRENE LPEZ, ERNESO R. ESCOO, yFFANI MONFORD-

DEN, AND MARINA PRADO-SEIMAN

3 Teories o Famil Terap ............................................................. 39JuLIE SHuLMAN AND gARIMA LAMbA

4 Workin With Hispanic/Latino(a) Immirant Families ................. 59ADAM ZAgELbAuM

5 Workin With Eropean Immirant Families ................................ 75gREgg KuEHL, ADAM ZAgELbAuM, AND JON CARLSON

6 Workin With Arican Immirant Families ................................. 103RObyN bRAMMER

7 Workin With Asian Immirant Families, Part I: Far East,Sotheast Asia, and Pacifc Islands ............................................... 121

A. ZAIDy MOHDZAIN

8 Workin With Asian Immirant Families, Part II: Soth Asia ..... 137MALA MADAHIL

9 Workin With Middle Eastern Immirant Families ......................151NAJI AbI-HASHEM



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vi Contents

10 Workin With Astralian Families: Inisile Immirants ............181SALLy HuNER

11 Immirant Families From Reions With Emerin Research ...... 195ADAM ZAgELbAuM

12 Workin With Intercltral Immirant Families ..........................211DOLORES D. ARvER AND JOy K. HARDEN

13 Te Ftre o Conselin Immirants and Teir Families ........... 229EvELyN RIvERA-MOSquERA, MARSHA MICHELL-bLANKS,ERNDIRA LPEZ-gARCA, AND OMAR FAAL

Appendix A: National Resorces on Cltral Competence ................... 261

Appendix b: Practical gidelines or Mental Health ProessionalsWorkin With Immirants ............................................... 267

Index ...................................................................................................... 269



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121

7Chapter

Working With AsianImmigrant Families,Part I: Far East, SoutheastAsia, and Pacifc Islands

A. Zaidy MohdZain

Te termAsian reers to those having origins o the native people o the Far East,Southeast Asia, and Indian subcontinent (U.S. Census Bureau, 2004b). Te U.S.Census Bureau (2004b) included Cambodia, China, Bangladesh, Burma (now

known as Myanmar), India, Indonesia, Japan, Laos, Korea, Malaysia, Pakistan,Philippines, aiwan, Tailand, and Vietnam. Another common term used isPacic Islander, which reers to those having origins in any original people oHawaii, Guam, Samoa, or other Pacic Islands such as Fiji or ahiti. Within the

Contents

Demographic Description ............................................................................122Immigration Experience ...............................................................................124

Te Family ................................................................................................... 125Counseling Issues .........................................................................................128Issues or Counselors ....................................................................................130Reerences .................................................................................................... 133



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122 A. Zaidy MohdZain

United States, it is common or these two groups to be lumped together, as theterm oten appearsAsian and Pacic Islander. For the purpose o this chapter, we

are reerring to those immigrants whose ancestors or origins come rom both theAsian continent and the Pacic Islands as Asian immigrants. Te term Orientalis outdated, and many Asian American clients may perceive it as an insult orinsensitive. Tey may in return view the counselors using the term as culturallyuninormed, which jeopardizes the counselors own rapport-building eorts. Amore acceptable term,Asian American, is represented by some 43 dierent eth-nic groups o people originated rom a large geographic area. As a group, Asian

Americans lack homogeneity, and there are large within-group dierences asexemplied by the very concept o diversity (Kim, Yang, Atkinson, Wole, &Hong, 2001; U.S. Department o Health and Human Services, 2001).

Demographic Description

According to the U.S. Census Bureau, in March 2002, there were about 12.5million Asian and Pacic Islanders who lived in the United States. Tis rep-resents some 4.4% o the total population (U.S. Census Bureau, 2003). In

the United States, Asian Indian, Chinese, Filipinos, Korean, and Vietnamesetogether made up about 80% o the Asian American population. Chinese wasthe largest group, representing some 24% o the Asian American population,ollowed by Filipinos, Asian Indian, Vietnamese, and Korean. In terms o thelocation in which Asian Americans lived in the United States, the U.S. CensusBureau (2004b) stated that 51% o them lived in the West, 19% lived in theSouth, 12% lived in the Midwest, and 19% lived in the Northeast. Nearly 95%o all Asians lived in metropolitan areas, and some 76% o Asian Americansare oreign born. Asian Americans alone constitute more than a quarter o the

oreign-born population in the United States (U.S. Census Bureau, 2004b; U.S.Department o Health and Human Services, 2001).

Te Chinese were among the rst Asians who came to the United Statesin the 1850s to build the transcontinental railroad or work in the gold mines,mainly in Caliornia. About at the same time period, Japanese came to work inthe sugar plantations o Hawaii, and some moved on to Caliornia. Tey wereollowed by Koreans and Filipinos. Asian Indians started coming to the UnitedStates in the early 1900s. Vietnamese and other Southeast Asians came in thelate 1970s; many o them had to ee their countries in the atermath o theVietnam War (U.S. Department o Health and Human Services, 2001).

Asian Americans, whether they are immigrants, reugees, or American bornand have been in the United States or generations, are still struggling with rac-ism and discrimination issues. As an extreme example, this author was ortunate



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Working With Asian Immigrant Families, Part I: East Asia 123

to run into Dr. Ronald akaki, a renowned proessor o multicultural educationand best-selling author. He shared his personal experience o how some in his

audience o public lectures came backstage to commend him on his ability tospeak English with no oreign accent and the shock they had when he inormedthem that he is a sixth-generation American (R. akaki, personal communica-tion, April 14, 1999). Perhaps it was because his physical appearance, look, anddemeanor were exemplied as Oriental. Te issues o having the eeling or per-ception o not being accepted as ull Americans and continuing to be regardedas oreigners by society at large continue to play into the psychic o many

Asian Americans to this day. Sue and Sue (2008) revealed the result o a surveyo a representative sample o some 1,000 adults undertaken by the Committeeo 100 to determine their attitudes toward Asian Americans. Te dominant per-ception o adult Americans, as revealed by the survey about Chinese Americans,is that Chinese Americans would be more loyal to China than to the UnitedStates, with the examples o over hal o the people surveyed believing thatChinese Americans would pass secret inormation to China, a quarter o thesample would disapprove someone in their amily to marry an Asian American,and some 17% would be upset i Asian Americans moved into their neighbor-hood. Recognizing the institutional racism, the Caliornia legislature approved

a bill on July 17, 2009, to apologize to the states Chinese American communityor racist laws enacted as ar back as 1849 (Liu, 2009).However, on the ip side o the coin, Asian Americans are also hailed as a

model minority in afrming and realizing the widely held concept o achievingthe American dream. Kluger (2009) reported a presentation at the annual con-vention o the American Sociological Association in San Francisco o research by

Jerey imberlake o the University o Cincinnati and Rhys Williams o LoyolaUniversity Chicago who surveyed 2,100 Ohioans to gauge the overall publicperception o immigrants. Te results indicated that Asians were uniormly

ranked rst in the wealth, intelligence, and sel-sufciency categories relative toEuropeans, Middle Easterners, and Latinos. On average, Asian Americans whencompared to any other ethnic group in the United States attain more educationand have a higher proportion (45%) concentrated in managerial and proessionalspecialty occupations, relative to 34% o the total population. Te U.S. CensusBureau (2004b) stated that in 2000, 44% o Asian Americans aged 25 and olderhad a college or proessional degree, compared to only 28% o the White popu-lation and 24% o the total population that had achieved that level o educa-tion. Te census data in 1997 revealed that 58% o Americans who descendedrom natives o the Indian subcontinent had undergraduate, graduate, or proes-sional degrees (U.S. Department o Health and Human Services, 2001). Asian

Americans are much more likely to earn a bachelors degree (51% compared to32% o non-Hispanic Whites), and the U.S. Census Bureau (2003) reported



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that in 2002, 87% o the 7.9 million Asian Americans aged 25 and older haveearned at least a high school diploma. Te average amily income or Asian

Americans tends to be higher than the national average. Te median income oAsian amilies was over $9,000 higher than the median income or all amilies($59,000 compared to $50,000) (U.S. Census Bureau, 2004b). Asian Indianand Japanese amilies median income were more than $10,000 higher than thato all Asian amilies, with Cambodian, Hmong, Korean, Laotian, Pakistanis,Tai, and Vietnamese amily incomes substantially lower than the medianor all Asian amilies. However, some subgroups o Asian Americans, namely,Hawaiian and other Pacic Islanders, Cambodian, Hmong, and Laotians, didnot have high educational attainment, and the poverty rates or Asians is similarto those o total population, with Hmong having the highest individual povertyrates, ollowed by Cambodians (U.S. Census Bureau, 2004b). Tereore, as welook behind the success myth, there exists a wide variation in the economicattainment o Asian Americans as a group (akaki, 1989; U.S. Department oHealth and Human Services, 2001). Tis is a prime example o the danger ostereotyping, because 17% o Asian and Pacic Islander amilies had incomeso less than $25,000 compared to 15% o non-Hispanic Whites amilies, whichin turn means that Asian and Pacic Islanders are more likely to live in poverty

than non-Hispanic Whites.

Immigration Experience

Counselors working with Asian immigrants need to be mindul that individualAsian immigrants may have dierent migration experiences. Chung, Bemak,Ortiz, and Sandoval-Perez (2008) stated that the immigration process itsel islled with a series o complex stressors that aect the mental health and quality

o lie o immigrant populations. Not all immigrants migrate voluntarily. Teactors aecting their migration experiences may range rom escaping the tyr-anny o a brutal regime or social and political security to seeking more reedomand economic and educational opportunities in the United States. Te immi-grants experiences o coming to the United States can also be diverse. Teyrange rom immigrants having suered a complete loss o all their possessions ora loss o close amily members, to having to risk their lie and witness their ellowreugees die in their attempts to escape oppressive regimes, to dealing with otherhorric events. Te traumatic journey can take its toll on the immigrants andtheir amilies, especially those without a social network o support. Regardlesso their migration circumstances, they must adapt to survive and prosper in thenew land. Tis adaptation process is oten gradual and slow, and it orces theimmigrants to cope with a set o dierent belies and behaviors in every acet



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o their lives such as child rearing, amily structure, gender roles, religious prac-tices, and others. Tese belies, behaviors, and liestyles are oten in sharp con-

trast with their amiliar cultural belies and behaviors. Te adaptation processrequires the immigrants to learn, understand, and internalize the new culture tothe extent that it becomes amiliar, controllable, and supportive.

Migrating rom one country to another and learning how to adapt to thenew place is much like being on a continuum with two extremes: enculturationand acculturation. Enculturation is a process o retaining ones indigenous cul-tural values, behaviors, knowledge, and identity. Tus, those who are closer tothis end o the continuum, that is, enculturation, are perceived to adhere moreto Asian cultural values such as collectivism, conormity to the norms, deer-ence to authority gures, emotional restraint, lial piety, hierarchical amilystructure, and humility (Chung et al., 2008; Kim, Atkinson, & Yang, 1999;Sue & Sue 2008). Te opposite or contrasting end o the spectrum is accul-turation, which is a process o adaptation to the dominant U.S. cultural norms.Tus, we see some Asian immigrants who completely identiy with mainstream

American culture, whereas others may develop adaptive bicultural identica-tion that enables them to eel comortable and unctional within mainstream

American culture as well as their culture o origin. Still there are those who

continue to eel uncomortable with lie in the United States and instead chooseto live and work exclusively within the connes o an ethnic enclave (Hong &Domokos-Cheng Ham, 2001; Sue & Sue, 2008). For the immigrant amilies,this transgenerational process takes each successive generation one step urthertoward acculturation, with the second generation usually being more accultur-ated than the rst, and the third generation one step more acculturated thanthe previous two (Chung et al., 2008; Hong & Domokos-Cheng Ham, 2001).Kim and Omizo (2003) suggested that Asian Americans who strongly adhere to

Asian cultural values tend to have less positive attitudes about seeking help and

are less willing to see a counselor relative to those who do not adhere strongly toAsian cultural values. Kim, Ng, and Ahn (2009), however, concluded in theirstudy o 61 Asian American clients at a counseling center at a large university onthe West Coast that client adherence to Asian cultural values was not a signi-cant predictor o counseling session outcome.

The Family

Generally, a dominant Asian cultural milieu is that o collectivism as opposedto individualism, a dominant cultural milieu in the United States. Collectivismemphasizes close amily ties, hierarchy, and order as opposed to independenceand autonomy o the individual. Asians concept o amily and how they dene



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amily may dier rom that o counselors coming rom mainstream Americanculture. Te amily relationships are oten closer than those in mainstream

American amilies. For instance, the concepts o being overly close or enmeshedor lacking boundaries may be interpreted dierently by counselors rom main-stream American culture than by their Asian immigrant amilies who comerom an Asian cultural background. Tese two dierent rames o reerence are

what make it more challenging to counsel Asian immigrant amilies. For exam-ple, clients rom Asian culture, especially those adhering very closely to Asianvalues, may exhibit interpersonal reliance and dependency. Although these maybe considered healthy cultural norms in Asian culture, the same cannot be saidin mainstream American culture. Counselors with a mainstream American cul-tural background who are not sufciently knowledgeable o these cultural normscan easily and inadvertently diagnose Asian immigrants as having a dependentpersonality disorder (Chung et al., 2008). Another example o cultural normsis that rst cousins are oten viewed and presented as i they are siblings by

Asian immigrants. It is a common experience or practice or cousins to grow upand be raised in the same household, typically cared or by the grandmother oreldest uncle or aunt. For some who are rom a Muslim culture, the act that twoinants were breast-ed by the same woman makes them siblings or their entire

lives. Tus, the worldview o Asian immigrants in terms o amily relationshipsand whom they consider as members o their amily may dier relative to main-stream Americans.

Asian immigrant amilies tend to be more hierarchical and patriarchal thanmainstream American amilies (Hong & Domokos-Cheng Ham, 2001; Sue &Sue, 2008). Asian Americans are more likely to live in households that are com-posed exclusively o amily members. In 2004, 76% o Asian Americans live inthis amily household arrangement compared to 67% o non-Hispanic Whiteand Arican American households (U.S. Census Bureau, 2004a). Tey place more

emphasis on the authority o parents over children and o the older sibling overyounger siblings. Other than the act that communication ows downward, thetradition dictates deerence to the elders. For instance, a married sons primaryallegiance (amily loyalty) remains with his parents, as opposed to the circum-stances in contemporary mainstream American culture. Sue and Sue (2008) alsopointed to the roles o the mother in a amily system among Asian Americans,among which is to serve and mediate communication within the unit. roubled

Asian Americans typically rely on their mothers to transmit messages to theirathers. Within this context, it is common to see adult Asian immigrants askingor and valuing the opinions o their parents or older siblings and relatives who arestill overseas when making important decisions here in the United States.

aking into account how culture shapes or inuences the expression andrecognition o various psychological distress, counselors take into account the



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amilys worldview and level o acculturation. Te case in point is a commondilemma Asian immigrants and their amilies are acing during amily counsel-

ing sessions. Because o their hierarchical culture, Asian immigrants may eeluneasy about disclosing their issues in the presence o their children, and thechildren may eel it is improper to expose their parents problems in their pres-ence (Hong & Domokos-Cheng Ham, 2001). Sue and Sue (2008) pointed outthat public display o strong emotions are considered to be signs o weaknessin terms o maturity or a lack o personal control. Tus, the ather may appearperipheral to mainstream American counselors, whereas within the context o

Asian cultural milieu, he is properly maintaining his role and position within theunit by remaining authoritative and distant and not appearing to be emotion-ally demonstrative or involved with his children. Sue and Sue (2008) cautionedcounselors working with Asian Americans to be careul in using counselingmicroskills that ocus directly on emotions, as it may be uncomortable and ashame- producing event or traditional Asian Americans. Tose emotions can beaddressed but in an indirect manner. For example, rather than placing emphasison the client by saying, You look troubled, a more ace-saving statement aboutthe generality or the event instead o the person is preerable, such as Tis pre-dicament would make anyone troubled.

Oten, the children o Asian immigrants who are raised and educated in theUnited States are more procient in and become more identied with main-stream American culture relative to their parents, who tend to have strongermemories and emotional ties to their Asian cultural roots. At the same time,the children are being bombarded with messages rom peers, schools, and themass media championing that Western standards are superior and better thantheir own. How they adapt to the majority culture and at the same time retaintheir connection to their culture o origin can produce enough stress within theindividual and the amily. Okubo, Yeh, Lin, Fujita, and Shea (2007) quoted a

scenario in which Asian youths behave in their negotiation and balance theirbicultural living by being more American outside o their home and being moreChinese or Indian at home. Tis dual living can be stressul and exhaustingand becomes more important when making critical choices such as uture careerplans, dating, and marriage (Okubo et al., 2007). Oten during counseling ses-sions, these intergenerational mixed with acculturation conicts play themselves

when immigrant youths accuse their parents o being old-ashioned or control-ling, and the parents complain that their children are rebellious or corrupted bythe host American culture. Tis cultural gap creates riction that can be intenseenough to lead to amily conicts. Tese parentchild conicts are the mostcommon presenting problems or Asian American college students seeking coun-seling (Lee, Su, & Yoshida, 2005; Sue & Sue, 2008). In their study o 8 Chinese

American youths with a median age o 16.8 years (SD= 1.36) in New York City



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with the number o years in the United States ranging rom 1 to 16, Okuboet al. (2007) ound that other than cultural values and cultural expectation,

Asian youths do consider their individual interests and amilial expectationswhen making career-related decisions. Te youths also actored in issues such asmaintaining the amily reputation, saving ace, caring or parents, and respectingelders wishes as well as their own goals in their chosen proession.

Asian American children oten ace greater pressure to succeed academi-cally, and they have more ear o academic ailures when compared to theirEuropean American counterparts (Sue & Sue, 2008). Schools in Asia are muchmore structured and regimented with stricter rules and regulations relative tothe public schools in the United States. In Asian countries, students are typicallyrequired to wear school uniorms. In the classroom, students may stay quietand listen to teachers. Te open discussion ormat, exibility, and egalitarianand participatory atmosphere in American public schools could be a source oconusion or Asian American immigrants. Asian American students tend tospend twice as much time each week on academic work compared to nonAsian

American students, but they also report eeling isolated, depressed, anxious, andthat they receive little or no praise or their accomplishment (Kao, 1995; Sue &Sue, 2008). Asian American parents may have specic career goals in mind or

their children, usually in technical elds or hard sciences (Okubo et al., 2007;Sue & Sue, 2008). Oten this is merely a reection on the part o the parentsabout their expectations and insistence and that they appear to be obliviousto the individual childs talent or interest. Hong and Domokos-Cheng Ham(2001) pointed out an oten-occurring misunderstanding between Asian immi-grant parents and public school teachers centered on the parents complaintso their children not having enough homework assigned to them, whereas theteachers advised them not to put too much academic pressure on their children.

Asian Americans place high value on education, and the successul perormance

o their children is viewed as an afrmation and validation o their good parent-ing skills along with an expectation o moving toward achieving higher socialstatus within the community. Tus parents oten have high expectations ortheir children to achieve academically, and rom an Asian collectivistic perspec-tive, education o children is also an investment in a amilys uture (Hong &Domokos-Cheng Ham, 2001; Sue & Sue, 2008).

Counseling IssuesAsian collectivist tradition does not distinguish the mind and body. It placesa premium o maintaining social and amilial harmony. Oten, the route

Asian Americans take toward that end is by discouraging their open display o



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emotions and avoiding exposure o personal weakness. Asians Americans aretaught to deny the experience and expression o emotions. It is more accept-

able to express psychological distress through the body. Tis cultural attributecontributes to a large amount o expression o somatic symptoms among Asian

Americans when compared to White Americans (U.S. Department o Healthand Human Services, 2001). In other words, Asian Americans do not necessar-ily suppress or repress aective symptoms, but rather it is the context in which

what is being presented and how it is presented. For example, a Chinese clientmay display somatic symptom such as aches and pains or atigue to a clini-cian but show depressive symptoms to others. Te U.S. Department o Healthand Human Services (2001) acknowledged that our present knowledge o thecounseling needs o Asian Americans is very limited and that Asian Americanshave the lowest rates o utilization o mental health services among ethnic grouppopulations. In a study o 242 Asian American college students at a large mid-

Atlantic university and a large university in Hawaii, Kim and Omizo (2003)showed an inverse relationship between adherence to Asian cultural values andattitudes toward seeking proessional psychological help. Te study also showedthe same inverse relationship between adherence to Asian cultural values and

willingness to see a counselor. Te study by Gloria, Castellanos, Park, and Kim

(2008) supported this contention that decreased adherence to cultural valueswas predictive o increased help-seeking attitudes among second-generationKorean American undergraduates.

Migration experience and adjustment challenge the very structure andorganization o the amily as a unit. Asian immigrant amilies may nd thattheir traditional Asian amily structure is no longer sustainable in this newadopted land. For example, Asian immigrant children, inuenced by the valueso mainstream American society, may demand greater autonomy and treat-ment along a continuum ranging rom less than hierarchical to egalitarian than

culturally permitted in traditional Asia settings. On the other hand, the rst-generation Asian immigrants are struggling in their negotiations to balance thepast and all those cultural backgrounds and attachments with the pragmaticpresent. Remember, when the newer generation is asking the older generationto redene themselves, it touches the core o the individuals sel-identity andhence the presence o a robust energy within each o the holon o the entiresystem, a dynamic that counselors have to grapple with when providing coun-seling services.

For immigrant couples who have to leave their parents behind in Asia, theirinability to care or aging parents may create constant eelings o guilt, especially

when they have no other siblings there to assume the responsibility. Some maychoose to sponsor their aging parents to immigrate and live with them in theUnited States. At their advanced age, the older parents oten nd it difcult to



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adjust to the new liestyle and culture in the United States, and or the couple,the entry o their parents into the nuclear amily will change their lie patterns.

Asian immigrants are not immune to universal issues such as in-laws and gen-eration conict. Tus, the solution about caring or older parents can be stressulor both the couple and their older parents.

Tere are amily rituals that Asian immigrants are accustomed to, and theyace an agonizing dilemma surrounding developmental issues such as births,

weddings, and deaths. Te rituals as practiced in mainstream American culturesmay seem insufcient and inadequate or some Asian Americans, and they arelet eeling guilty and despondent over their inability to carry out the ull gamuto rituals as they experienced in their native land. Tey oten travel to their homecountries to continue and ollow up with a more elaborate and corrected ver-sion o the rituals. Rituals such as welcoming a newborn or planning a weddingcan be postponed, but a uneral has a special urgency and meaning, hence itsproound eects on the immigrants. (Hong & Domokos-Cheng Ham, 2001)

Issues or Counselors

Engaging Asian immigrants in counseling poses a unique challenge or coun-selors. Counselors need to become more responsive to a culturally adaptedcounseling approach when counseling Asian immigrants who tend to retainstrong cultural values (Kim et al., 2009; Portland, 2009; Sue & Sue, 2008).Te structural approach in counseling Asian immigrants, with its emphasis lesson insights but more on behavioral changes and the interventions that ocus ona amilys organization and its communication in the present, seems closer tothe Asian cultural milieu. Hammond and Nichols (2008) recommended thatcounselors use a collaborative partnership approach, although seemingly known

or its orceul directive interventions, in their attempts to make their interven-tions eective. o be eective when working with immigrant amilies, coun-selors must develop sel-awareness o their own eelings, attitudes, and beliesabout immigrants and working with them (Portland, 2009). Counselors need tobe exible and practical to provide eective interventions that are ocused andclear and to learn about their clients and the particulars o the amilys culture interms o roles, rules, values, and relationships (Portland, 2009; Poulsen, 2009).Te goal o the intervention is or the clients to develop new perspectives that

will lead them to adopt new actions, not by pushing clients to change but byunderstanding and afrming them via reaching and motivating them to acceptresponsibilities or changing their behaviors (Hammond & Nichols, 2008). Teprerequisite, according to Hammond and Nichols (2008), is or the counselors



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to make active eorts to elicit and acknowledge what their clients think and eeland, at the same time, work as respectul collaborative partners beore embark-

ing on the tasks o challenging them to change. As helping proessionals, coun-selors are working in a constant state o mediating the inuences o culturalorces within sel, clients, and others, and within this context, they must beproactive in responding to the needed knowledge, awareness, and skills neces-sary to be o service to their clients (Portman, 2009).

From the outset, when a counselor orms an alliance with his or her clients,the goals have always been to ree the identied patient o the symptoms, toreduce conict and stress or the amily, and or the amily to learn new ways ocoping (Minuchin & Fishman, 1981). Counselors must consider the behaviors,values, and priorities relating to other developmental landmarks such as datingpractices, marriage, and gender roles in the context o cultural backgrounds otheir Asian American clients (Madathil & Sandhu, 2008). At the same time, thissubtle process enables the counselor to gather data about the amilys existinghierarchies, values, and norms while afrming and acknowledging each membero the amily. In a roundabout way, the joining process is conducive to the Asiancultural milieu, taking into account the Asian immigrant clients cultural expec-tations such as the counselor is a proessional with expert knowledge and that he

or she respects the hierarchical structure o common patriarchal Asian amilies.Te counselor is letting the clients know that he or she understands them and isworking with and or them. Generally, these attempts by the counselor to gainacceptance and admission to the amily are viewed as congruent with what typi-cal Asian immigrants expect rom counseling.

Asian immigrants tend to dene their presenting problems in concrete terms,and they expect the counselor, being an expert, to provide them with solu-tions. Coming or counseling treatment may be viewed as bringing shame to theamily. Mental and emotional disorders carry a stigma within the community.

Guilt and shame within the context o Asian loss o ace carry a big stick thatimplies that the entire amily is losing respect and status within the community

when one o them is shamed. Tat identied patient is then positioned in anuntenable place and is under heavy pressure to keep the harmony and order

within the unit by minimizing any conicts and problems that could shame andbring guilt to the amily (Chung et al., 2008; Ho, 1990; Kim et al., 1999; Sue &Sue, 2008). Tus, a counselor needs to careully balance his or her attempts toidentiy the problem while appearing to respect the clients cultural backgroundin a congruent manner. Oten, the clients initial description o the presentingproblems may appear to the counselor as one in which the client externalizes theroot causes and spends a lot o time complaining and blaming. It is not uncom-mon to hear a client who lost his job to attribute such loss to his wies inability



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to execute household chores and duties or to attribute their childs poor schoolperormances on the wies spoiling and babying the child too much.

In the context o Asian immigrants cultural milieu, the counselor can use thetechniques o relabeling, reraming, and therapeutic paradox in his or her attemptto interrupt the sequences o problem-generating behaviors o amily members.Tis attempt is congruent with the concept o saving ace but is deemed moreimportant in the context o collectivistic, hierarchical amily structure o Asianimmigrants in which no one in the amily is blamed or the sequences o prob-lematic behavior, but instead the expert, in the person o counselor, continuesto honor and respect each member o the amily by afrming their roles andplace in the unit. Counselors need to relabel or rerame the behavioral sequenceo the presenting problems to make solutions o the presenting problems appeardoable and within the capability and competence o the amily. Once the am-ily buys this, it is easier to move gradually to other issues beyond the presentingproblems. Te counselor, being accepted as an expert by the clients, can easilyencourage the members to interact with each other and with the counselor. Tecounselor can observe the process through which the presenting problems otenemerge. On occasion, the counselor will be called to intensiy the current trans-actions to gauge the amilys understanding and acceptance o challenges and

the ways they perceive reality. Te counselor regulates the transactions in termso aect, repetition, and duration. Observing interactions within the session isthe hallmark o the systemic approach o counseling. Counselors adopting thisapproach may attempt to shape the competence o the amily members in tak-ing care o themselves (without the presenting problem) rom the very moment

when they meet the amily and begin the counseling relationship (Nichols &Schwartz, 2006).

Oten, an ability to converse in English can place the amily unit in a hier-archical inversion situation, especially when the parents are unable to speak or

master the language (e.g., English), and they have to rely on their children totranslate, a dynamic that oten inverses the traditional hierarchical structureo the amily. Te parents will nd themselves more isolated rom mainstreaminstitutions and have to rely on and become dependent on their children toconnect to the outside world. Tis hierarchical inversion can have a destructiveeect on the amily. Just as it is an awesome task or each o the amily membersto adjust to the new environment, it is also an equally challenging task or thecounselor to ormulate eective intervention strategies acceptable to the am-ily members. It can either make or break the counseling relationship with thisamily.

Counselors also need to be careul when asking each amily member todescribe what he or she perceives o the amily patterns. Oten the response is verymuch inuenced by actors such as whether a amily member was born and raised



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in Asia or born in the United States. Hong and Domokos-Cheng Ham (2001)illustrated such instances in which the parents, born and raised in Asia, may iden-

tiy a amily pattern o responsibility and sacrice and hence the discipline (I didthat or your own good, It hurts me more than you ever know when I punishyou), a theme consistent with Asian cultural values, whereas the children, bornand raised in the United States, may identiy the same values by relabeling themas stiing restriction, authoritarian, and perhaps downright abusive.

Te transactions within the amily may reveal the act that the children,exposed to the egalitarian concept in the mainstream culture, expected to beasked instead o being told, and the parents may perceive such a request as akinto reducing their position within the amilial hierarchy or downgrading theirstatus or perhaps perceive it as an act o teenage rebelliousness, deance, ordownright disrespectulness. In their attempts to reestablish and maintain suchtraditional hierarchical structure, and not reduce their stature as parents byacquiescing to the demands o the teenage children, they will continue with thesame old amily patterns to maintain control, hence perpetuating the homeo-stasis. A keen counselor can detect such scenarios when the observed memberstarts using the words demand or telling as opposed to lets see or ask-ing. It is incumbent on the counselor to be conscientious in tracking all o

these amily patterns and in ormulating culturally appropriate treatment plansand goals.When working with recent Asian American amilies, counselors need to be

aware o the within-group diversity and how they relate to the counseling pro-cess. Acculturation issues remain a ocus that counselors must assess throughoutthe counseling sessions.

ReerencesChung, R. C., Bemak, F., Ortiz, D. P., & Sandoval-Perez, P. (2008). Promoting the

mental health o immigrants: A multicultural/social justice perspective.Journal oCounseling and Development, 86, 310317.

Gloria, A. M., Castellanos, J., Park, Y. S., & Kim, D. (2008). Adherence to Asian culturalvalues and cultural t in Korean American undergraduates help-seeking attitudes.

Journal o Counseling and Development, 86,419428.Hammond, R. ., & Nichols, M. P. (2008). How collaborative is structural amily

therapy? Te Family Journal: Counseling and Terapy or Couples and Families, 16,

118124.Ho, C. K. (1990). An analysis o domestic violence in Asian American communities: A

multicultural approach to counseling. Women and Terapy, 9, 129150.Hong, G. K. & Domokos-Cheng Ham, M. (2001). Psychotherapy and counseling with

Asian American clients: A practical guide. Pacic Grove, CA: Sage.



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Kao, G. (1995). Asian American as model minorities? A look at their academic peror-mance.American Journal o Education, 103, 121159.

Kim, B. S. K., Atkinson, D. R., & Yang, P. H. (1999). Te Asian values scale: Development,actor analysis, validation, and reliability. Journal o Counseling Psychology, 46,342352.

Kim, B. S. K., Ng, G. F., & Ahn, A. J. (2009). Client adherence to Asian cultural val-ues, common actors in counseling, and session outcome with Asian American cli-ents at a university counseling center. Journal o Counseling and Development, 87,131142.

Kim, B. S. K. & Omizo, M. M. (2003). Asian cultural values, attitudes toward seekingproessional psychological help, and willingness to see a counselor. Te CounselingPsychologist, 31, 343361.

Kim, B. S. K., Yang, P. H., Atkinson, D. R., Wole, M. M., & Hong, S. (2001). Culturalvalue similarities and dierences among Asian American ethnic groups. CulturalDiversity and Ethnic Minority Psychology, 7, 343361.

Kluger, J. (2009, August 12). Stereotypes persist even where immigrants dont. ime.Retrieved August 12, 2009, rom: http://www.time.com/time/health/arti-cle/0,8599,1915768,00.html

Lee, R. M., Su, J., & Yoshida, E. (2005). Coping with intergenerational amily con-ict among Asian American college students.Journal o Counseling Psychology, 47,211222.

Liu, L. W. (2009, July 22). Caliornia apologizes to Chinese Americans. ime.Retrieved August 12, 2009, rom http://www.time.com/time/nation/article/0,8599,1911981,00.html

Madathil, J. & Sandhu, D. S. (2008). Indelity in Asian Indian marriages: Implicationsor counseling and psychotherapy. Te Family Journal: Counseling and Terapy orCouples and Families, 16,338343.

Minuchin, S. & Fishman, H. C. (1981). Family therapy techniques. Cambridge, MA:Harvard University Press.

Nichols, M. P. & Schwartz, R. C. (2006). Family counseling: Concepts and methods(7th ed.). Boston, MA: Allyn and Bacon.

Okubo, Y., Yeh, C. J., Lin, P. Y., Fujita, K., & Shea, J. M. (2007). Te career decision-making process o Chinese American youth.Journal o Counseling and Development,85,440449.

Portman, . A. A. (2009). Faces o the uture: School counselors as cultural mediators.Journal o Counseling and Development, 87,2127.

Poulsen, S. S. (2009). East Indian amilies raising ABCD adolescents: Cultural and gen-erational challenges. Te Family Journal: Counseling and Terapy or Couples andFamilies, 17,168174.

akaki, R. (1989). Strangers rom a diferent shore: A history o Asian Americans. New York:Little, Brown.

Sue, D. W. & Sue, D. (2008). Counseling the culturally diverse: Teory and practice(5th ed.). Hoboken, NJ: John Wiley & Sons.

U.S. Census Bureau. (2003, May). Te Asian and Pacic Islander population in theUnited States: March 2002; Population characteristics. Retrieved October 14,2009, rom http://www.census.gov/prod/2003pubs/p20-540.pd

http://www.time.com/time/health/arti-cle/0,8599,1915768,00.htmlhttp://www.time.com/time/health/arti-cle/0,8599,1915768,00.htmlhttp://www.time.com/time/nation/article/http://www.census.gov/prod/2003pubs/p20-540.pdfhttp://www.routledgementalhealth.com/working-with-immigrant-families-9780415800617http://www.census.gov/prod/2003pubs/p20-540.pdfhttp://www.time.com/time/nation/article/http://www.time.com/time/health/arti-cle/0,8599,1915768,00.htmlhttp://www.time.com/time/health/arti-cle/0,8599,1915768,00.htmlhttp://www.time.com/time/health/arti-cle/0,8599,1915768,00.html


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U.S. Census Bureau. (2004a, March). Current population survey, annual social and economicsupplement, 2004, racial statistics branch, population division. Retrieved October 14,

2009, rom http://www.census.gov/population/socdemo/race/api/ppl-184/tab3.pdU.S. Census Bureau. (2004b, December). We the People: Asian in the United States[Census2000 Special Reports]. Retrieved October 14, 2009, rom http://www.census.gov/prod/2004pubs/censr-17.pd

U.S. Department o Health and Human Services, Ofce o the Surgeon General,SAMHSA. (2001). Culture, race and ethnicity: A supplement to mental health.InMental care or Asian Americans and Pacic Islanders(pp. 107126). Rockville,MD: Author. Retrieved October 14, 2009, rom http://www.surgeongeneral.gov/library/mentalhealth/cre/sma-01-3613.pd

http://www.census.gov/population/socdemo/race/api/ppl-184/tab3.pdfhttp://www.census.gov/http://www.surgeongeneral.gov/http://www.routledgementalhealth.com/working-with-immigrant-families-9780415800617http://www.surgeongeneral.gov/http://www.census.gov/http://www.census.gov/population/socdemo/race/api/ppl-184/tab3.pdf


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