Asian-American acculturation, severity of concerns, and willingness to see a counselor.

Abstract

Asian Americans at a major West Coast university were surveyed to determine how severe each of 24 problems was for them and to assess their willingness to see a counselor for each problem. Factor analysis reduced the 24 problems to 8 areas of concern. A repeated measures analysis of variance revealed that severity ratings for the 8 concerns were related to acculturation and ethnicity. With severity ratings as covariates, a repeated measures analysis of covariance was computed for willingness to see a counselor ratings. Willingness to see a counselor was found to be related to both acculturation and gender across all 8 concerns. Women expressed greater willingness to see the counselor than did men and low-medium acculturated students expressed greater willingness to see a counselor than did high-acculturated students. In an extensive review of research on counseling and psychotherapy with Asian Americans, Leong (1986) concluded that Asian Americans' underutilization of mental health services is well documented, despite some evidence of higher than normal need for services. A number of hypotheses, most of which assume a conflict between the psychotherapy process and the values of traditional A*sian-American culture, have been offered to explain this pattern of underutilization. For example, it has been hypothesized that Asian Americans avoid mental health services because to seek outside help will bring shame upon their families (Root, 1985; Webster & Fretz, 1978). It also has been hypothesized that Asian Americans underutilize mental health services because they are socialized to internalize stress and repress feelings (Sue & Kitano, 1973; Sue & Morishima, 1982). Furthermore, they may be socialized to believe that psychological problems are the result of bad thoughts and a lack of willpower and that they must resolve problems of this type on their own (Root, 1985). Moreover, when Asian-American students do seek help, their presenting concerns are often different from Caucasian students. Sue and Kirk's (1975) study of students at the University of California, Berkeley, revealed that Asian-American students overutilized the campus counseling center but underutilized the psychiatric clinic when compared to general student use patterns. Sue and Kirk suggested that this was due to the less stigmatized services provided by the counseling center (e.g., academic and career counseling) than the services provided at the psychiatric clinic (e.g., mental health counseling); Asian Americans may be more reluctant than other groups to seek help for stigmatized mental health concerns. Tracey, Leong, and Glidden (1986) found additional support for this hypothesis. They reported that Asian-American clients were more likely to cite educational or vocational concerns