Culturally sensitive counseling for Asian Americans/Pacific Islanders.

There is a constellation of considerations for counselors dealing with Asian American/ Pacific Islander clients. In order to provide culturally sensitive counseling, counselors need to know and respect the traditional values of the particular ethnic group. Beyond this, the counseling process may be enhanced by attention to other salient factors involving acculturation, enculturation, personal issues, and environmental variables. The task demands idiosyncratic tailoring of the counseling process to meet the diverse needs of this growing ethnic minority group.

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The strong multicultural component of the United States population has prompted the need for counselors to consider multicultural factors when communicating with their clients (Zhang & Dixon, 2001). Consequently, policies and practices in counseling have and continue to be revised to address this need. For example, new guidelines on multicultural education, training, research, practice, and organizational change have been drafted to reflect the knowledge and skills needed for the counseling profession in the midst of dramatic sociopolitical changes in our society (American Psychological Association, 2002).

Among the many cultural groups, Asian Americans are the second fastest growing ethnic minority group in the United States (U.S. Bureau of the Census, 2002). When Asian Americans are grouped with Pacific Islanders, this population makes up the fastest growing ethnic community (Maki & Kitano, 2002). As of 2000, there were reportedly 10.2 million individuals of this cultural group living in the United States, representing an increase of 46% since 1990 (Kim & Omizo, 2003). Recent immigration levels suggest that this number will grow rapidly in the near future.

Within the population of Asian Americans/Pacific Islanders, more than 20 nationality groups exist. Some of these include the Chinese, Filipino, Japanese, Asian Indian, Korean, Vietnamese, Cambodian, Hmong, Laotian, Thai, Hawaiian, Samoan, and Guamanian. Of these groups, the Chinese, Filipino, Korean, and Vietnamese populations have increased in number at a fast pace (Maki & Kitano, 2002). In general, these groups settle along coastal areas of the United States, especially in the states of California, New York, Hawaii, Texas, and New Jersey (U.S. Bureau of the Census, 1997).

Much diversity exists within this population of Asian Americans/Pacific Islanders. There is a wide variety of identities, languages, and cultures. Even within each ethnicity, differences in values, behaviors, and attitudes will vary based on the generation, ethnic experience, socioeconomic status, acculturation, enculturation, age, gender, religion, region, sexual orientation, visibility (appearance), and history of discrimination. These factors will mold a person's perspective of himself or herself as well as how life is viewed. Naturally, counselors working with Asian American/Pacific Islander clients will need to complement their understanding of the basic information about the original culture with an exploration of these additional factors.

The Basic, Traditional Cultural Values

Initially, counselors must be knowledgeable of the basic traditions that have been recognized in this multicultural group of Asian Americans/Pacific Islanders. Generalized values, behaviors, and attitudes cannot be unilaterally affixed to each client; however, an awareness of such traditions is an essential foundation for counselors' appreciation of the client's cultural background. A myriad of value categories have been empirically identified in the literature related to this cultural group (Kim, Atkinson, & Umemoto, 2001; Maki & Kitano, 2002). These categories are identified and described below.

Self-control

Self-control is highly valued among this ethnic group. Self-control may be demonstrated by exercising poise and calmness in the face of highly emotional experiences, maintaining dignity when confronted with pain or suffering, and sustaining modest and appropriate behavior. Modesty may be evidenced in depreciating one's own accomplishments rather than boasting about success, for example.

Collectivism/Solidarity

Individual rights, needs, and desires are suppressed in order to elevate the welfare of the group. There is a strong sense of commitment to and obligation in satisfying group interests and goals. This is operationalized by placing others' needs ahead of one's own needs.

In an effort to maintain group solidarity, differences of opinion are typically reconciled in order to retain harmony and reach consensus. Accommodations are made to show respect for the feeling of others and foster a spirit of cohesiveness. In addition, reciprocity in repaying another person's favor is expected.

Filial Piety 

Parental respect is a powerful value among this ethnic group. Children are expected to love their parents and obey the norms established by the family. Interdependence and trust are cultivated within the family system. Any individual member's achievement is attributed to the family's accomplishments.

Shame

Related to filial piety, shame is the mechanism used to deter inappropriate behaviors that might tarnish the family's reputation. Any individual family member's failures impact the family as a whole.

Deference to Authority Figures

Age and intelligence are revered. Ancestors and elders are assumed to have more wisdom through life experiences and, therefore, deserve more respect than younger people. Individuals with advanced education command respect as authority figures, from whom much can be learned.

Achievement

Hard work and tenacity are regarded as virtues. Applied to school and work, these virtues should facilitate success in academic and career accomplishments. Priority is placed on educational and occupational achievement.

Unassuming Attitude

There is no desire to attract special attention to the individual. This may manifest itself in an avoidance in utilizing psychological counseling. Relying on inner resources and self-determination, the individual may reject the help of others in order to evade the perception of weakness.

Counseling Implications for Clients Who Hold Traditional Values

Culturally sensitive counselors enhance the counseling process for Asian Americans/Pacific Islanders. In a study by Zhang and Dixon (2001), the researchers examined the differential effectiveness of culturally responsive and culturally neutral counselors. Based on the input of 60 students who were interviewed under both conditions, the culturally responsive counselors were viewed as more experet, more attractive, and more trustworthy than the culturally neutral counselors.

What, then, are the conditions for orchestrating culturally sensitive counseling sessions for Asian Americans/Pacific Islanders who hold traditional ethnic values? In response to this question, counselors should consider what the context of the counseling session will be, how the counseling sessions will be implemented, and who will conduct the counseling sessions in order to maximize positive outcomes.

What Content Might Be Targeted

There is a great need for psychological services among the cultural group to deal with a variety of problems including academic, interpersonal, health/substance abuse, dating, bicultural and biracial issues, family difficulties due to emerging cultural differences, marginality, difficulties relating within various subgroups, and the experience of racism (Leong, 1986). Yet, the level of need for psychological counseling in these areas has not been proportional to the rate of utilization of the services (Kim & Omizo, 2003). This may well reflect the traditional value of being unassuming and avoiding bringing negative attention to one's self or family.

In consideration of this, initial counseling sessions for a client who ventures out to seek help should be prudently planned. Since an interest in and value of educational and occupational achievement exists, a willingness to discuss these non-threatening issues may be pursued. Subsumed in these discussions should be the influence of parental expectations. Tang (2002) emphasizes the relevance of paternal influence, in particular, as a powerful influence on career choice, Further, Kim and colleagues (2001) also advise the introduction of task-oriented content rather than personal-oriented topics. When trust and comfort is established, more sensitive issues may be gradually introduced. As Kim and Omizo (2003) suggest, when Asian Americans seek help for academic or career concerns, it may open the door for exploration of issues related to personal or health problems.

How Counseling Sessions Might Be Implemented

To provide more effective cross-cultural counseling, counselors must be aware of their communication style, counseling style, and client expectations. A large repertoire of verbal and nonverbal behaviors will be beneficial (Zhang & Dixon, 2001). Language barriers may be mediated by action-oriented and artistic therapies. For example, concrete activities such as sand play could allow clients to express their worlds and engage in self-discovery of subconscious themes, emotions, or beliefs (Enns & Kasai, 2003). Such action-oriented sessions could be structured to match a client's competence in language (O'Sullivan, 1994). Kim, Liang, and Li (2003) examined the relationship between counselor nonverbal behavior and counseling session outcomes. European American counselors who tended to smile more and make postural shifts more frequently that their Asian American counterparts received high scores on productivity and involvement in the session by 112 volunteer clients. Nevertheless, Zhang and Dixon (2003) report seemingly contradictory findings, indicating that Asian international students preferred counselors of similar ethnicity.

Deliberate selection of counseling styles/ approaches must complement appropriate communication style in order to enhance outcomes with Asian Americans/Pacific Islanders. Individuals who adhere to traditional ethnic values can experience greater comfort when the focus of the session is on the expression of thoughts rather than feelings. This is consistent with the value of retaining self-control in an unassuming manner (Kim et al., 2001). In encouraging the sharing of thoughts, counselors of this cultural group are advised to use a directive approach that is characterized by hierarchical authority. Clients prefer to attribute high levels of respect and wisdom to their counselors (Kim et al., 2001).

In addition, counselors need to present themselves as culturally responsive. In the Zhang and Dixon (2001) study, culturally responsive counselors displayed pictures and crafts from the native land, had a world atlas with a map of Asia visible, used salutations in the client's own language, and expressed interest in knowing more about the client's culture. The perception of participants was that these counselors were more open to different cultures, more capable of relating to people of different cultures, and more capable of being helpful in resolving problems than culturally neutral counselors. Realistically, being culturally responsive does not imply a comprehensive knowledge of each culture; rather, it means conveying an interest and respect for other cultures, evidencing an eagerness to learn about other cultures, and appreciating the particular heritage of the client (O'Sullivan, 1994; Zhang & Dixon, 2001).

A final consideration in cross-cultural counseling is to identify the expectations of the client. Clients with a high adherence to ethnic values may strive to maintain a role in counseling that protects the family honor. And, clients may expect immediate symptom relief from a goal-oriented authoritative counselor (Kim et al., 2001). Symptom relief could be realized by identifying resources to meet the client's needs, suggesting problem-solving options, and offering specific advice.

Who Conducts the Counseling Sessions

Only tentative conclusions can be drawn from the current research to address this issue. Kohatsu, Dulay, Lam, Concepcion, Perez, Lopez, and Euler (2000) caution that racial mistrust can influence the counseling process. These researchers report that Asian Americans do harbor racial mistrust of African Americans. In another study referred to by Zhang and Dixon (2003),Asian international students reportedly preferred to seek help from an older counselor of similar ethnicity. Certainly, more studies are needed in this area to support or refute these contentions. Of greater significance seems to be the culturally responsive nature of the counselor, since empathetic involvement has been demonstrated to be a key predictor of counselor credibility Akutsu, Lin, & Zane, 1990).

Beyond the Basic Traditional Values: Additional Factors, Additional Complexities in Counseling

A significant influence on the effectiveness of multicultural counseling is the level of acculturation and enculturation. Acculturation is the extent to which the individual assimilates the American culture into his or her values, attitudes, and behaviors. Enculturation is the degree to which a person retains and identifies with the culture of origin. The interaction of these two variables results in four characterizations: (1) high in assimilation and low in enculturation; (2) high in assimilation and high in enculturation; (3) High in enculturation and low in assimilation; and (4) low in enculturation and low in assimilation (Maki & Kitano, 2002).

These four characterizations will account for increasing complexity in the counseling process. Individualizing sessions to mesh with the client's levels of acculturation and enculturation should facilitate more salient outcomes. Clients who are determined to be high in assimilation and low in enculturation have embraced the American culture and have a command of the English language. Typically, individuals fitting this description have spent a longer time in the United States functioning in integrated, mainstream settings. Maki and Kitano (2002) recommend that counselors possess a knowledge of the American culture and language to deal more effectively with these clients.

People who reflect high levels of both acculturation and enculturation are comfortable with the American culture as well as the native culture. Contacts and interactions straddle both the dominant society and the ethnic community. Counselors must, therefore, demonstrate culturally sensitive practice.

Immigrants and older generations with limited exposure to the dominant culture will probably represent low assimilation and high enculturation. These clients adhere to traditional ethnic values and may possess limited language skills. Counselors need to rely on action-oriented activities, learn a limited but functional vocabulary in the client's native tongue, and assume a culturally sensitive role.

Finally, low levels of acculturation and enculturation suggest clients who reject both the American culture and the ethnic culture. These individuals present deviance in assimilating into society in general. More clinical challenges may be faced with these clients, as counselors search to uncover the cause of such alienation.

These suggestions are further complicated by a variety of client variables (Kim et al., 2001). These variables encompass personal factors such as generation, age, gender, sexual orientation, socioeconomic status, educational level, prior counseling experience, and language proficiency. In addition, environmental factors such as geographic location, peer group, family system, religion, and political climate will produce differential interaction effects.

Closure

There is a constellation of considerations for counselors dealing with Asian American/Pacific Islander clients. In order to provide culturally sensitive counseling, counselors need to know and respect the traditional values of the particular ethnic group. Beyond this, the counseling process may be enhanced by attention to other salient factors involving acculturation, enculturation, personal issues, and environmental variables. The task demands idiocycratic tailoring of the counseling process to meet the diverse needs of this growing ethnic minority group.

References

Akutsu, P., Lin, J., & Zane, N. (1990). Predictors of utilization of counseling among Chinese and Caucasian students: A test of the proximal-distal model. Journal of Counseling Psychology, 37. 445-452.

American Psychological Association (2002). Guidelines on multicultural education, training, research, practice, and organizational change for psychologists.

Enns, C., & Kasai, M. (2003). Hakoniwa: Japanese sand play therapy. The Counseling Psychologist, 31(1), 93-112.

Kim, B., Atkinson, D., & Umemoto, D. (2001). Asian cultural values and the counseling process: Current knowledge and directions for future research. The Counseling Psychologist, 29(4), 570-603.

Kim, B., Liang, C., & Li, L. (2003). Counselor ethnicity, counselor nonverbal behavior, and session outcome with Asian clients: Initial findings. Journal of Counseling and Development, 81, 202-207.

Kim, B., 7 Omizo, M. (2003). Asian cultural values, attitudes toward seeking professional psychological help, and willingness to see a counselor. The Counseling Psychologist, 31(3), 343-361.

Kohatsu, E., Dulay, M., Lam, C., Concepcion, W., Perez, P., Lopez, C., & Euler, J. (2000). Using racial identity theory to explore racial mistrust and interracial contact among Asian Americans. Journal of Counseling and Development, 78, 334-342.

Leong, F. (1986). Counseling and psychotherapy with Asian Americans: Review of literature. Journal of Counseling Psychology, 33, 196-206.

Maki, M., & Kitaono, H. (2002). Counseling Asian Americans. In P. Pedersen, J. Draguns, W. Lonner, & J. Trimble (Eds.), Counseling across cultures (pp. 109-131). Thousand Oaks, California: Sage Publications.

O'Sullivan, K. (1994). Understanding ways: Communicating between cultures. Alexandria, NSW: Hale and Iremonger Press.

Tang, M. (2002). A comparison of Asian American, Caucasian American, and Chinese college students: An initial report. Journal of Multicultural Counseling and Development, 30, 124-134.

U.S. Bureau of the Census. (1997). Selected characteristics of the population by citizenship: 1996. Retrieved from http://www, census. gov/population/socdemo/race/api

U.S. Bureau of the Census (2002). Selected characteristics of the population by citizenship: 2001. Retrieved from http://www.census. gov/population/socdemo/race/api

Zhang, N., & Dixon. D. (2001). Multi-culturally responsive counseling: Effects on Asian students' ratings of counselors. Journal of Multicultural Counseling and Development, 29, 253-262.

Zhang, N., & Dixon, D. (2003). Acculturation and attitudes of Asian international students toward seeking psychological help. Journal of Multicultural Counseling and Development, 31, 205-222.

Alexis Ann Schoen, Graduate Student, School Counseling Program, Holy Family University.

Correspondence concerning this article should be addressed to Ms. Alexis Ann Schoen, 211 W. County Line Road. Huntingdon Valley, PA 19006.