How Psychotherapists Address Hypothetical Multiple Relationships Dilemmas with Asian American Clients: A National Survey

Abstract

LITTLEFORDThis study examined how psychotherapists address hypothetical nonsexual multiple relationships dilemmas with Asian American clients and identified predictors of conservative decisions and the use of culture-based rationales. This survey of 787 Asian American and non-Asian American psychotherapists revealed that clinicians rely on mostly their personal policies and seldom focus on the clients' cultural backgrounds. Psychotherapists who consider their clients' Asian culture have more cultural knowledge and awareness, have been mental health providers longer, and are Asian American and female. Clinicians who avoid multiple relationships tend to cite formal policies as justification and are less likely to consider clients' cultural worldviews, the therapeutic relationship, or their own values. The results are discussed in terms of specific revisions needed in the American Psychological Association Ethics Code, the benefits of more frequent consultation with colleagues and supervisors about ethical dilemmas, and recommendations for psychotherapists.Since the 1970s, clinical and counseling psychology have attempted to be more inclusive of cultural diversity, encouraging psychotherapists to consider in their practices the impact that culture has on people's values, worldviews, behaviors, and emotions (

Ethical decision making in mental health contexts: Representative models and an organizational framework.

“…There also have been models or guidelines developed for serving clients within specifi c contexts, such as (a) religious communities (e.g., Hill & Mamalakis, 2001 ), (b) managed care (e.g., Belar, 2000 ;Tjelveit, 2000 ;Younggren, 2000 ), (c) child clinical psychology (e.g., Mannheim et al, 2002 ), (d) outpatient care ( Truscott, Evans, & Mansell, 1995 ), and (e) play therapy ( Seymour & Rubin, 2006 ). And there are recommendations for psychologists who counsel specifi c populations of clients, such as Asian Americans (e.g., Littleford, 2007 ) or those vulnerable to exploitive dual relationships ( Gottlieb, 1993 ). These are just a few of any number of publications that address specifi c ethical challenges in mental health practice.…”

Not your submissive china doll: Counseling Asian American female survivors of sexual assault at the intersection of racialized sexism.

“…The current extant literature focuses mainly on the experiences of White clinicians working with Asian American clients. For example, when examining psychotherapists’ hypothetical reactions to nonsexual multiple relationship dilemmas with their Asian American clients, Littleford (2007) observed that the majority-White survey population would rely more on their personal policies than their clients’ cultural values and backgrounds. The ones who did emphasize their clients’ cultural backgrounds were often more culturally knowledgeable, had more clinical experience, female, or Asian American themselves.…”