Cognitive behavior therapy with Asian Americans.

Abstract

iwamasa, hsia, and hinton (U.S. Census Bureau, 2012). Asian Americans are the most likely of any racial or ethnic group to live in mixed-ethnic neighborhoods and marry across ethnic groups, with about 74% born abroad and 50% who speak English fluently (Pew Research Center, 2013).Despite this diversity, researchers often lump together Asians of diverse cultures, and as a result, the generalizability of these studies is limited (Pan, Huey, & Hernandez, 2011). Furthermore, participants in such studies are often English-speaking students attending U.S. universities-a group that is not representative of Asian Americans as a whole. Acknowledging these limitations, some researchers have identified similarities across Asian ethnic groups that can be useful to clinicians. In addition, awareness of the marked cultural, political, and environmental differences among and within groups may assist therapists in providing culturally competent treatment. However, it must be stressed that each culture, as well as each individual, has unique characteristics that have to be fully explored and understood; this chapter merely serves as a guide.In the United States, Asian Americans are often viewed homogenously as either a model minority (Gupta, Szymanski, & Leong, 2011;Kiang, Huynh, Cheah, Wang, & Yoshikawa, 2017) or "forever foreign" (Zhou, 2004). Unfortunately, both views work against the provision of culturally competent care. Assuming that a client is a model minority member can lead the therapist to overlook significant stressors, whereas viewing the client as forever foreign may cause the therapist to assume the client is incapable of healthy adaptations. Competent clinicians recognize the heterogeneity of Asian Americans, including differences related to language (i.e., preferred spoken language, fluency, multilingual abilities), religion and spirituality, gender roles, education and employment status, identity, generational status, and immigration history (including intergenerational experiences as refugees or immigrants). HISTORICAL AND CULTURAL BACKGROUNDThe histories of many Asian countries overlap because of their proximity and mutual conquests. For example, part of the Japanese language is based on the Chinese language, and many still use the Asian lunar calendar. Some negative sentiment remains between some Asian countries because of past political conflicts (e.g., Japan and China) and current ones (e.g., North Korea and South Korea). Culturally competent care requires awareness of the potential for such histories to affect an Asian American client's perceptions, beliefs, and behaviors. A comprehensive review of the histories of specific Asian American cultures is beyond the scope of this chapter,Copyright American Psychological Association. Not for further distribution.cognitive behavior therapy with asian americans 131 and readers are encouraged to consult Hall and Okazaki (2002) and Leong et al. (2007). ImmigrationSome Asian Americans, such as Japanese Americans, have been established in the United States for many g...

Ethnic minority cultural adaptations of cognitive behavioral therapy.

“…Over 30 different ethnic groups fall under the group of Asian Americans, who continue to be one of the fastest-growing ethnic groups in the United States. Iwamasa, Hsia, and Hinton (2018) summarized the historical and cultural background of Asian American groups, including immigration, cultural values and traditions, and other considerations such as gender roles, family roles, and health beliefs, and how those may affect therapy. They provided a case example illustrating how CBT can be adapted for Asian Americans.…”

“…Two chapters in Iwamasa and Hays's (2018) recent volume on CBT with culturally diverse populations focus on East Asians (Iwamasa, Hsia, & Hinton, 2018) and South Asians (Shah & Tewari, 2018). Iwamasa, Hsia, and Hinton's (2018) chapter summarized the vast diversity among the population of Americans of Asian descent.…”

A Systematic Narrative Review of Cognitive-Behavioral Therapies with Asian American Youth

“…Experts have highlighted the overlap between core features of CBT and some common values shared across Asian cultures, suggesting that CBT may be appropriate for AsA (Chen & Davenport, 2005;Iwamasa et al, 2019). It is important to note, however, that there is significant heterogeneity in Asian values endorsed within and across AsA subgroups (Kim et al, 2001).…”

“…Core features of CBT include its structured, and often manualized, nature (Hall et al, 2019) and the directive approach of CBT therapists (e.g., providing psychoeducation, assigning homework; Hwang et al, 2006). Scholars suggest that structured interventions may be more acceptable and engaging for AsA youth (Sandil, 2006) and that AsA might be especially inclined to complete between-session assignments (Iwamasa et al, 2019;Sandil, 2006). Given that AsA typically exhibit respect for authority figures and value interpersonal harmony (Hynes, 2019), therapeutic relationships wherein clinicians demonstrate expertise, explicitly suggest skills, and educate clients might be particularly desirable for AsA (Chen & Davenport, 2005).…”

“…CBT for youth often emphasizes family member involvement (e.g., parent-training; keeping parents informed about what their child is learning in therapy; Khanna & Kendall, 2009). Family -often ranging from the nuclear to the extended family in AsA culture (Iwamasa et al, 2019) -is generally very important to AsA, and it is not uncommon for family members to regularly accompany AsA clients to therapy (Hwang et al, 2006). Given the cultural emphasis on AsA family interdependence (Kim et al, 2001), family involvement, which has been shown to enhance youth psychotherapy efficacy in general (Haine-Schlagel & Walsh, 2015), might also increase treatment engagement for AsA youth (Sandil, 2006).…”