Carefully Tailored Assessment and Treatment

Abstract

The authors discuss the importance of issues related to family, community, immigration, and acculturation in providing psychodynamic psychotherapy for Asian Americans. Despite differences between specific sub-ethnic groups of Asian Americans, many of these groups share an emphasis on group connectedness and family unity that can have important implications for individual development and can influence the course of psychotherapy with these patients. The authors first review the effects of immigration and dislocation (e.g., culture shock, mourning for the loss of family, friends, and familiar cultural environment) on Asian Americans, and then describe the types of changes and stresses the acculturation process can produce. These include guilt at leaving family behind in the country of origin and intergenerational conflict between parents and their more Westernized children, especially concerning social life, dating, and marriage. The authors then use Asian Indian family structure and community life to illustrate the types of effects family organization and roles and community context have on Asian American individuals. In the second half of the article, the authors discuss how these cultural factors can influence the process of psychotherapy and describe techniques that may improve the chances of successful therapy (e.g., being sensitive to patients' reluctance to discuss personal issues outside the family, being more willing to involve family members in the therapy process).