Effective psychotherapy for Asian Americans: From cultural accommodation to cultural congruence.

Psychotherapy is a culturally encapsulated healing practice that is created from and dedicated to specific cultural contexts (Frank & Frank, 1993; Wampold, 2007; Wrenn, 1962). Consequently, conventional psychotherapy is a practice most suitable for dominant cultural groups within North America and Western Europe but may be culturally incongruent with the values and worldviews of ethnic and racial minority groups (e.g., D. W. Sue, Arredondo, & McDavis, 1992). Culturally adapted psychotherapy has been reported in a previous meta-analysis as more effective for ethnic and racial minorities than a set of heterogeneous control conditions (Griner & Smith, 2006), but the relative efficacy of culturally adapted psychotherapy versus unadapted, bona fide psychotherapy remains unestablished. Furthermore, one particular form of adaptation involving the explanation of illness-known in an anthropological context as the illness myth of universal healing practices (Frank & Frank, 1993)-may be responsible for the differences in outcomes between adapted and unadapted treatments for ethnic and racial minority clients. The present multilevel-model, direct-comparison meta-analysis of published and unpublished studies confirms that culturally adapted psychotherapy is more effective than unadapted, bona fide psychotherapy by d = 0.32 for primary measures of psychological functioning. Adaptation of the illness myth was the sole moderator of superior outcomes via culturally adapted psychotherapy (d = 0.21). Implications of myth adaptation in culturally adapted psychotherapy for future research, training, and practice are discussed.

As an extension of F. T. L. Leong's (1996) integrative model, this article presents the cultural accommodation model (CAM), an enhanced theoretical guide to effective cross-cultural clinical practice and research. Whereas F. T. L. Leong's model identifies the importance of integrating the universal, group, and individual dimensions, the CAM takes the next step by providing a theoretical guide to effective psychotherapy with culturally different clients by means of a cultural accommodation process. This model argues for the importance of selecting and applying culture-specific constructs when working with culturally diverse groups. The first step of the CAM is to identify cultural disparities that are often ignored and then accommodate them by using current culturally specific concepts. In this article, several different cultural "gaps" or culture-specific constructs of relevance to Asian Americans with strong scientific foundations are selected and discussed as they pertain to providing effective psychotherapy to this ethnic minority group. Finally, a case study is incorporated to illustrate application of the CAM. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

The model minority stereotype depicts Asian Americans as a group that has succeeded in America and overcome discrimination through its hard work, intelligence, and emphasis on education and achievement - a modern-day confirmation of the American Dream. A large body of work by Asian critical scholars condemns this image and charges that it conceals more sinister beliefs about Asian Americans and other racial minorities in America. Is this critique correct? Does the model minority stereotype really mask hostility toward Asian Americans or breed contempt for other minorities? This article presents the results of an empirical study into the model minority stereotype. Using 1990, 1994, and 2000 General Social Survey data (including some of the very data used by critical scholars to establish the existence of this stereotype), we confirm claims that some non-Hispanic white Americans think that Asian Americans as a group are more intelligent, harder working, and richer than other minorities and that some think Asian Americans are more intelligent and harder working than whites. But we also discovered that these ideas are not usually linked with negative views of Asian Americans (or of other minorities, for that matter). Indeed, we found weak support for the contrary position - that those who rate Asian Americans higher than other minorities, or particularly higher than whites, are more likely to hold other positive views about Asian Americans, immigration, African Americans, and government programs supporting these groups. Our study nonetheless confirms the scholarly suspicions in one crucial respect: non-Hispanic whites who have positive views of Asian Americans are less likely to think that Asian Americans are discriminated against in both jobs and housing, thus tending to support the claims of some Asian critical scholars that positive stereotypes about Asian Americans tend to be associated with a failure to recognize continuing discrimination. In these data, however, this complacency by whites about prejudice against Asians does not translate into hostility toward government programs to alleviate the problems of Asian or African Americans.

This study examines when and where residential context and communicative factors help and hurt Asian Americans’ political participation both within and beyond coethnic boundaries. Using multilevel analyses, this paper found that living in ethnically homogeneous residential areas and using ethnic media increase Asian-related political awareness. However, these coethnic features in their communicative structure did not directly bridge Asian communities to the political participation. Instead, coethnic features indirectly galvanize Asian Americans’ political participation, which may spill over to more general domains of political participation.

Evaluating the Thematic Nature of Microaggression among Racial and Ethnic Minority Surgeons.

Culture shapes how individuals perceive and respond to others with mental illness. Prior studies have suggested that Asians and Asian Americans typically endorse greater stigma of mental illness compared to Westerners (White Europeans and Americans). However, whether these differences in stigma arise from cultural variations in automatic affective reactions or deliberative concerns of the appropriateness of one's reactions to mental illness remains unknown. Here we compared implicit and explicit attitudes toward mental illness among Asian and Caucasian Americans. Asian Americans showed stronger negative implicit attitudes toward mental illness relative to Caucasian Americans, suggesting that cultural variation in stigma of mental illness can be observed even when concerns regarding the validity and appropriateness of one's attitudes toward mental illness are minimized. Asian Americans also explicitly endorsed greater desire for social distance from mental illness relative to Caucasian Americans. These findings suggest that cultural variations in mental illness stigma may arise from cultural differences in automatic reactions to mental illness, though cultural variations in deliberative processing may further shape differences in these immediate reactions to mental illness.

In 2009, President Obama signed an Executive Order calling for strategies to improve the health of Asian Americans and to seek data on the health disparities in Asian American subgroups.1 Data on Asian American subgroups are scarce and many health disparities remain unknown. The purpose of this Advisory is to highlight the gaps in existing research on cardiovascular disease (CVD) among Asian Americans, and to serve as a call to action on behalf of the American Heart Association to address these areas of need. Asian Americans are the fastest growing racial/ethnic group in the United States, representing 25% of all foreign-born people in the United States.2 They are projected to reach nearly 34 million by 2050.3 Several major Federal surveys (eg, the American Community Survey, the National Health Interview Survey, and the Behavioral Risk Factor Surveillance Survey) only recently started to classify Asian Americans into 7 subgroups: Asian Indian, Chinese, Filipino, Korean, Japanese, Vietnamese, and Other Asian. The first six of these subgroups together constitute >90% of Asian Americans in the United States.4 Although some data are available on Asian subgroups from these major federal surveys, in general, these data are not available for public use because of the privacy concerns resulting from the small sample sizes within subgroups. This situation limits their utility for health-related research. Because health surveys and questionnaires almost universally combine persons of Asian ancestry into a single group, the heterogeneity within this classification is masked. Socioeconomic and cultural factors have been found to be associated with CVD and its risk factors, which is why it is important to understand these differences among Asian subgroups. The Table shows the number of persons in each group based on the most recent US Census data available (American Community Survey, 2008), with the recognition that …

In two historical Supreme Court cases from the early part of the twentieth century, when only whites and blacks could be United States citizens, two Asian American immigrants made the startling move of that they were and, therefore, deserved to be naturalized. The two petitioners - Takao Ozawa and Baghat Singh Thind - claimed they were white by dint of skin color, anthropological evidence, culture, and various other qualities suggesting they belonged to America. The petitioners' claims resonated with one central message: I am just like you. Thind's and Ozawa's claims ultimately failed. The petitioners were denied citizenship because the Supreme Court, not surprisingly, held that they did not qualify as white, and that despite their claims to the con-trary, Ozawa and Thind were just These cases are instructive not only for what they tell us about racial hierarchy and barriers faced by Asian Americans at the time, but also for what they say about current issues surrounding Asian American identity and the ineffectiveness of when one will invariably be labeled as different. Ozawa's and Thind's claims to whiteness and its attendant privilege serve as stark historical examples of a current phenomenon exhibited by some Asian Americans today: making assimilationist claims to the privilege of dominant, white culture in contem-porary debates implicating the concerns of Asian Americans. Echoes of Ozawa's and Thind's claims to whiteness sound throughout the rhetorical positions that some Asian Americans have assumed in current debates, includ-ing affirmative action. In this debate, the controversial minority myth has served as the foundation for Asian Americans' claims resembling Ozawa's and Thind's, claims assuring racial insiders, I am just like you. This paper situates these historical and current claims to whiteness by Asian Americans in the context of Catharine MacKinnon's feminist critique of the liberal model of equality, which forces those seeking to claim similarity to dominant norms. By virtue of traditional equal protection doctrine's similarly situated require-ment, those who are the same must be treated equally, and conversely, those who are different may be treated as such. MacKinnon's critique demonstrates how women seeking gender equality and racial minorities seeking racial equality, at the very least, face a patent unfairness insofar as they are required to equate themselves with their oppressors to remedy the conditions of their subordination. Furthermore, at worst, women and racial minorities face a doctrinal trap in which they are never meant to gain equality, since women and racial minorities are socially de-fined as Equality claims ultimately collapse inward, as they are founded on a disingenuous struc-ture that treats and as exact opposites, when, in actuality, they bear a hierarchical relationship to one another, with difference masking the subordination of women and racial minorities. Therefore, the dif-ference that these rights seekers must overcome is actually the subordinated positions they hold in gender and racial hierarchies, respectively. MacKinnon's critique of the liberal equality model's foundation in and underscores the im-possibility of historical and contemporary claims to whiteness by Asian Americans. Despite their valiant efforts to show that they did indeed belong, Ozawa and Thind failed to overcome the social understanding of their ineluctable Ozawa's and Thind's assertions that they were the same as whites (in fact, that they were white) act as a metaphor for the claims of some of today's Asian Americans, whose claims to white privilege belie the particulari-ties and difference of today's Asian Americans. This paper explores examples, both old and new, that reveal the falsity of similarity to a white norm in the face of the real, race-based structural inequities facing many Asian Americans that constitute their difference. In addition, this paper aims to highlight how Ozawa's, Thind's and contemporary Asian Americans' claims to white privilege by claiming sameness ultimately reinforce the white privilege to which these claimants aspire.

Screening thresholds: one size does not fit all

Moving Forward: Asian Americans in the Discourse of Race and Social Problems

In this article, we formulate a new bicultural model of social work with ethnic minorities. The suggested model connects acculturation orientations, professional interventions and burnout amongst social workers working with ethnic minority clients. We tested this model in a sample of Arab Israeli social workers (n = 299). The study results confirmed that ethnic minority social workers working with ethnic minority clients used interventions that may be classified as either rooted in the minority or the majority culture. Arab Israeli social workers used slightly more often interventions rooted in the minority than the majority culture; however, the two types of intervention were complementary rather than contradictory. Acculturation orientations of Arab Israeli social workers were connected to their choice of professional interventions. Specifically, a higher preference for separation was associated with more frequent use of professional interventions rooted in the minority culture. In contrast, a higher preference for integration was associated with more frequent use of interventions rooted in both minority and majority cultures. More frequent use of interventions rooted in the majority culture was associated with a lower level of burnout and a higher level of personal accomplishment, whilst more frequent use of interventions rooted in the minority culture was associated with a higher level of burnout. Based on the obtained results, an integrative approach to education and training of social workers and social work practice with ethnic minorities is advocated.

Meeting Asian/Arab American StudiesThinking Race, Empire, and Zionism in the U.S. Sunaina Maira (bio) and Magid Shihade (bio) I am the witness of the massacre I am the victim of the map I am the son of simple words . . . —Mahmoud Darwish, from "Poem of the Land"1 Speak, your lips still have their liberty Speak, still yours is the spoken word . . . Speak, for the truth is alive even now Speak, say all you wish you had said. —Faiz Ahmed Faiz, from "Speak" (1941)2 Why link Asian and Arab American Studies? Why should we speak of Arab American studies in Asian American studies, or have a conversation in ethnic studies about points of convergence and divergence between these two areas? Is it in order to recognize an emerging ethnic studies field in the U.S., with all the limitations that a politics of recognition based on multiculturalism entails? Is it to extend a comparative ethnic studies approach that is increasingly transforming Asian American studies while raising questions about the definition of ethnic and racial boundaries? In our view, the answer is all of these, but much more. We argue here that speaking of Arab and Asian [End Page 117] American studies in the same breath is ultimately valuable because it illuminates a broader and more urgent issue: the need to develop a fuller analysis of U.S. empire. The meeting of Asian American and Arab American studies has been increasingly highlighted in discussions after 9/11 as it has become apparent that Asian American—particularly South Asian—and Arab American communities as well as Muslim Americans more generally, have similar experiences as targets in the "war on terrorism" waged by the United States. The question of how to produce intellectual and political knowledge to respond to the everyday crisis of empire is urgent at this particular moment, but we want to point out that it has always been so—the conjuncture between Asian/Arab American studies helps to situate U.S. empire in a much longer historical trajectory that links movements in, and out of, Asia and the Middle East. Imperial power operates by obscuring the links between homeland projects of racial subordination and minority co-optation and overseas strategies of economic restructuring and political domination. This link between the domestic and global fronts of empire can be exposed only if we expand our frame of analysis to consider the ways in which categories of subjects such as "Asian American" and "Arab American" are positioned in relation to U.S. empire. Ethnic studies has focused in large part on documenting, understanding, and challenging the construction of ethnic and racial boundaries as they intersect with other axes of domination, such as gender, sexuality, and class, within the nation. However, there has also been a movement in Asian American studies to acknowledge the transnational dimensions of Asian communities and histories, on the one hand, and the paradoxes and pitfalls of a multiculturalist identity politics, on the other. So the meeting of Arab/Asian American studies highlights the question of borders, and the political and epistemological work of boundaries in shaping our understanding of power and resistance. It helps us to locate the issue of ethnic and racial borders within the larger frame of U.S. empire, and to understand that the question facing Asian American studies today is how to intellectually and institutionally confront imperial, not just national or ethnic, politics. This has always been the challenge for ethnic studies, which has often remained confined within a national frame. [End Page 118] The purpose of linking Asian and Arab American studies is not to colonize Arab American studies within an ever-expanding rubric of pan-Asian ethnicity, but to do the opposite: to challenge the ever-expanding borders of an imperial project that operates through direct as well as proxy wars, neo-colonial occupation, and client states. Ultimately, it is for Arab Americanists themselves to decide where they want to be situated in the academy and how Arab American studies should be introduced into the curriculum. Research on Arab Americans is growing and gaining more academic recognition through new faculty hires and programs, though it continues to occur in...

Brief Reports: Psychiatric Illness and Substance Abuse Among Homeless Asian-American Veterans

The authors discuss the complexities of working with clients with dual minority status (i.e., sexual orientation and ethnicity). The authors explore the multiple contexts that influence ethnic and sexual minority clients' self‐concept. A case illustration of a Puerto Rican lesbian college student is presented, and suggestions for implementing multiple lenses in counseling dual minority clients are offered.

We studied the characteristics of psychological service providers who treat ethnic minority clients in a representative random sample of psychologists listed in the National Register of Health Service Providers (NR) in 1986. Ethnic minority providers saw more than twice the proportion of ethnic minority clients than did non-Latino White providers (24.0% and 11.7%, respectively). Providers with cognitive-behavioral clinical/theoretical orientations saw significantly more ethnic minority clients than did those with psychodynamic or other orientations. Providers with eclectic orientations saw significantly more ethnic minority clients than did those with psychodynamic orientations, but eclectic providers did not differ from any other provider orientation group. The results suggest that more ethnic minority providers are needed and that other providers need to increase their ethnic minority clientele.