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Cultural Diversity & Ethical Boundaries: Coping with the Challenges
Ethics continuing education social worker CEUs

Section 1
Cultural and Historical Perspectives in Counseling Asian American Clients

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In this section, we will discuss ethical, cultural and historical perspectives in counseling culturally different clients who are Asian American. We will also discuss the implications of these cultural and historical perspectives.

♦ The Highly Successful Minority?
As you know, there are more than 1,500,000 Asian Americans residing in the United States. Although this constitutes less than one percent of the U.S. population, I have found that ethically, there is much that can be learned from the experiences of the Asian Americans.

The stereotype of Asian Americans is as the highly successful minority. The Chinese and Japanese seem to have exceeded the national median income as well as the national educational standards. In addition mental health statistics reinforce the belief that Asian Americans are well-adjusted and functioning effectively in society. As you are probably aware, they have low rates of juvenile delinquency, psychiatric contact and hospitalization, and divorce.

However, a closer analysis of Asian Americans does not support this successful stereotype. This inconsistency between the stereotype and facts raises ethical concerns. As you may have guessed, the higher median income does not take into account the higher percentage of multiple wage earners in Asian American families. In addition, it does not show that while Asian American wage earners may have higher levels of education, their wages are disproportionate with their training.

Regarding education, there is a contrasting picture of extraordinarily high educational attainment and a large undereducated mass. Obviously it is also now widely recognized that areas like Chinatown represent ghetto areas with prevalent unemployment, poverty, health problems, and juvenile delinquency. Continuing mass murders committed over the years have been traced to Chinese juvenile gangs operating in Chinatown.

Finally, the underutilization of mental health facilities may be due to low rates of socioemotional adjustment difficulties. However, it is common knowledge that much of the mental illness, adjustment problems, and juvenile delinquency among Asian American populations are hidden. Clearly the discrepancy between officially reported and actually occurring rates may be due to such cultural factors as the shame and disgrace associated with admitting to emotional problems, the handling of problems within the family, and the manner of symptom formation. Do you take this inconsistency between the stereotype and facts into consideration in counseling your Asian American client?

♦ History
The history of Asian Americans may be responsible for some of the current problems facing these culturally different clients in counseling. The effects of this history on the counseling situation with Asian American clients today will be illustrated via the case study of Chiyo (chee’-yo) in the next section. As you probably know, Asians in America have suffered some of the most inhumane treatment ever accorded to any immigrant group.

Historically the treatment of Asians was highly correlated with the needs of the United States. In the 1800s the systematic harassment of the Chinese resulted in legal discrimination that denied them the rights of citizenship through laws like the Chinese Exclusion Act of 1882. As you are well aware, discrimination against the Japanese was most obvious during World War II when 110,000 Japanese Americans were incarcerated in concentration camps.

However, as you likely know, discrimination against Japanese had been going on for years preceding World War II. When the Japanese began having economic success in the United States, immigration from Japan was restricted through a "gentleman’s agreement." Clearly Asians were often used by white profiteers and subsequently blamed for economic downturns.

Besides historical influences ethically, as you are well aware, cultural influences should also be taken into account in counseling culturally different clients who are Asian American. Obviously traditionally, in the Asian American family, age, sex, and generational status are primary determinants of role behavior. The dominant orientation of Asian families has always been conservative and resistant to change. Built into family relationships are strong values that stress the need to approach problems subtly and indirectly.

I have found that above all, the welfare and integrity of the family is of great importance. For this reason the instillation of guilt and shame, as well as appeals to familial obligation, are heavily relied upon to keep family members in line and suppress deviations from the norm. Sound like something you’ve seen in your Asian American client? This will be illustrated when we consider the case study of Chiyo in the next section.

♦ How to Cope With the Culture Conflict.
Have you noticed in your Asian American clients, as I have, that the clashing of the traditional Asian culture with Western influences often results in a culture conflict for the Asian American client? Bombarded on all sides by peers, schools, and the mass media upholding Western standards as better than their own, Asian Americans frequently encounter extreme culture conflict that leads to much pain and agony.

3 Coping Skills Utilized by Asian Americans
According to Derald Sue, most Asian American culturally different clients cope in one of three ways.
1. First
, some will become traditionalists and remain loyal to their own ethnic group. It goes without saying that traditionalists adhere closely to the norms, standards, and values of their traditional Asian families.
2. Second, some become marginalists. Marginalists often attempt to become overwesternized by rejecting traditional Asian values. Instead of being concerned with the family, marginalists define their pride and self-worth by their ability to acculturate into the dominant white society.
3. Finally, the third coping method for Asian Americans dealing with the culture-conflict is to rebel against parental authority while trying to develop a new identity.

Think of your Asian American client. How does he or she cope with the culture conflict? Via traditionalism and remaining loyal? Via marginalism and overwesternization? Or via rebelling while trying to develop a new identity?

♦ The Implications on Counseling for the Asian American Client
Obviously, these influences have a number of implications on counseling for the Asian American culturally different client. The utilization of psychiatric resources may be low because cultural values inhibit self-referral. As you know, Asian American families stress the importance of obedience and conformity to elders, as well as high achievement and other behaviors that bring honor to the family name. Thus public admission of personal problems, such as going to therapy, is suppressed.

In addition, Asian Americans emphasize the restraint of strong feelings and associate psychological problems related to strong feelings with shame and disgrace. Thus in counseling a traditionalist Asian American client, a therapist needs to be aware that the client is likely to experience intense feelings of shame and guilt at admitting that problems exist. In addition it is important to deal with issues of confidentiality. I have found that because traditionalist Asian American clients present problems in an indirect manner, it is often easier to counsel the client by initially responding to these superficial problems until a degree of rapport and trust can be formed.

As you can see, therapists working with traditionalist Asian American clients need to be aware that superficial problems often mask deeper conflicts. As a result, if your Asian American client is a traditionalist, you as a therapist may need to alter your usual style of counseling and therapy. Regarding marginalist Asian American clients, the therapist has an ethical obligation to help his or her client sort out identity conflicts. If your Asian American client is a marginalist, you will likely need to deal with the issue of cultural racism and its potential effects on your Asian American culturally different client.

Do you have an Asian American client? Ethically, what concerns should you have in counseling him or her in light of the information presented in this section? The APA Code of Ethics states, "Psychologists are aware of and respect cultural, individual, and role differences, including those based on age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, and socioeconomic status and consider these factors when working with members of such groups."  

In this section, we have discussed cultural and historical perspectives of Asian Americans as those perspectives relate to counseling Asian American clients. We have also discussed some of the implications of these perspectives on counseling.

In the next section, we will look at a specific case with an Asian American client named Chiyo and analyze the influences impacting the counseling experience.

Peer-Reviewed Journal Article References:
Ahn, L. H., Kivlighan, D. M., Jr., & Hill, C. E. (2021). Helping skills courses: The effects of student diversity and numeric marginalization on counseling self-efficacy, counseling self-stigma, and mental health. Journal of Counseling Psychology.

Benuto, L. T., Singer, J., Newlands, R. T., & Casas, J. B. (2019). Training culturally competent psychologists: Where are we and where do we need to go? Training and Education in Professional Psychology, 13(1), 56–63.

Choudhury, T. K., Stanton, K., & Balsis, S. (2018). Contextual consideration of the emergence of alexithymia: A case study highlighting cross-cultural client factors and limited English proficiency. Psychotherapy, 55(1), 80–88.

Kim, B. S. K., Li, L. C., & Liang, T. H. (2002). Effects of Asian American client adherence to Asian cultural values, session goal, and counselor emphasis of client expression on career counseling process. Journal of Counseling Psychology, 49(3), 342–354.

Wang, S., & Kim, B. S. K. (2010). Therapist multicultural competence, Asian American participants' cultural values, and counseling process. Journal of Counseling Psychology, 57(4), 394–401.

What are three ways Asian American clients might cope with the culture conflict? To select and enter your answer go to Ethics CE Test.

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