Frederick T. L. Leong

Barriers to providing effective mental health services to Asian Americans.

Using the research framework recommended by L. Rogler, R. Malgady, and D. Rodriguez (1989), the current paper examines the barriers to providing effective mental health services to Asian Americans. Beginning with the recognition that Asian Americans consists of numerous heterogeneous subgroups, the issue of the stereotype of Asian Americans as the “model minority” was also discussed. The primary focus of the paper is on Stages 2, 3, and 4 within the Rogler et al. (1989) model and the identification and discussion of cultural factors that hinder the delivery of mental health services to Asian Americans. The paper is therefore organized into these three sections: (a) help-seeking or mental health service utilization, (b) evaluation of mental health problems, and (c) psychotherapeutic services. In each of the sections, not only are the barriers to delivery of effective mental health services discussed but so are the research and methodological problems as well as some directions for future research. This critical review of the literature has been prepared with the goal of serving as a “blueprint” for us to pursue rigorous but relevant research to identify and reduce these cultural barriers to providing effective mental health services to Asian Americans.

Individualism-Collectivism, Social-Network Orientation, and Acculturation as Predictors of Attitudes Toward Seeking Professional Psychological Help Among Chinese Americans

Several culturally based variables were used to predict the patterns of help-seeking attitudes among a sample of Chinese-American students (TV = 219) in a large midwestern university. Cultural values operationalized by H. C. Triandis, R. Bontempo, M. J. Villareal, M. Asai, and N. Luccas (1988) Individualism-Collectivism Scale, social support attitudes operationalized by A. Vauxs (1985) Network Orientation Scale, and the continuous variable of acculturation operationalized by the Suinn-Lew Asian Self-Identity Acculturation Scale (R. M. Suinn, K. Rickard-Figueroa, S. Lew, & P. Vigil, 1987) were selected as predictors of attitudes as measured by E. H. Fischer and J. L. Turners (1970) Attitudes Toward Seeking Professional Psychological Help Scale. Each of the 4 independent variables were found to be significant predictors of attitudes towards seeking professional psychological help. The counseling and research implications of the results are discussed. Research on cross-cultural issues that have an impact on counseling and psychotherapy has gained an impetus only since the 1970s (Atkinson, 1985). Atkinson (1985) examined reviews that had critically summarized studies dealing with the relationship between cultural and counseling variables (Atkinson, 1983; Harrison, 1975; Sattler, 1977). Three important characteristics of the studies conducted before 1985 stood out. First, most of the research had focused on relations between African Americans and Caucasians and had not examined other racial and ethnic groups. Second, the settings in which a large proportion of the studies had been conducted were mental health outpatient clinics or psychiatric hospital inpatient units, not college counseling centers. Third, either a survey or an archival research design had been used in a majority of the studies. These observations can also be made about a large number of studies that have examined the role of ethnic and racial variables in areas of psychology other than those of counseling and psychotherapy. Atkinson (1985) recommended that researchers study a number of different ethnic and racial groups, investigate within-group variables, such as self-designated identity and cultural commitment, and do more research in college settings. These recommendations are valuable for studies on a number of psychological issues and processes. Some of these issues include attitudes, values, experiences, expectations, beliefs, and social-support systems of members of different ethnic groups (Root, 1985). These factors affect a number of behaviors, one of which is the act of seeking professional psychological help. Research has shown that members of non-Caucasian ethnic groups

Counseling and Psychotherapy With Asian-Americans: Review of the Literature

This article is divided into three sections. The first section concerns the diagnosis and assessment of Asian-America ns and covers the following issues: (a) symptom expression, (b) therapist bias, (c) problems with the use of interpreters, and (d) problems with the use of clinical and personality tests. The second section, on counseling and psychotherapy, is divided into three subsections: (a) client variables, (b) therapist variables, and (c) counseling process and outcome. The subsection on client variables covers such issues as the personality of Asian-America ns, language problems, the acculturation process, and counseling expectations. The subsection on therapist variables includes discussion of therapist bias, training bias, lack of intercultural skills, and culture-specific knowledge. The therapy process and outcome subsection reviews empirical studies, clinical case studies, and articles with treatment strategies and recommendations. Research issues as well as research recommendations for each of the areas reviewed are identified and discussed in the third section.

Toward a new approach to the study of personality in culture

We review recent developments in the study of culture and personality measurement. Three approaches are described: an etic approach that focuses on establishing measurement equivalence in imported measures of personality, an emic (indigenous) approach that studies personality in specific cultures, and a combined emic-etic approach to personality. We propose the latter approach as a way of combining the methodological rigor of the etic approach and the cultural sensitivity of the emic approach. The combined approach is illustrated by two examples: the first with origins in Chinese culture and the second in South Africa. The article ends with a discussion of the theoretical and practical implications of the combined emic-etic approach for the study of culture and personality and for psychology as a science.

A Proposal for Internationalizing Counseling Psychology in the United States: Rationale, Recommendations, and Challenges

This article, written by the coeditors of The Counseling Psychologists (TCP) International Forum section, reviews the status of counseling psychology from an international perspective and presents a rational and modest proposal for promoting counseling psychologys commitment to global perspectives. The brief history of TCPs International Forum section is reviewed and specific recommendations for internationalizing counseling psychology are put forth. These recommendations are organized along (a) methods of psychological science, (b) profession-based initiatives, (c) Division 17 (counseling psychology) initiatives, and (d) program-specific activities. The marked challenges to internationalizing counseling psychology are also addressed.

Factor Structure of the Self-Construal Scale Revisited Implications for the Multidimensionality of Self-Construal

The Self-Construal Scale (SCS) is an important measure of self-construal. However, new data are needed on the structure of the SCS using more appropriate statistical techniques and investigating the existence of multiple (i.e., more than two) factors. Exploratory and confirmatory factor analyses of data from two groups of European American and Asian/Asian American college students reveal six factors underlying items on the SCS that seem to represent four specific aspects of Independence and two specific aspects of Interdependence. Results also provide initial support for the relative usefulness of these new factors in exploring between-groups differences. Implications for the conceptualization of self-construal and future research are discussed.

The English Version of the Chinese Personality Assessment Inventory

The article examines the structure of the Chinese Personality Assessment Inventory (CPAI), an indigenous Chinese assessment instrument, in two English-speaking samples. In Study 1, the English version of the CPAI was developed and administered to a sample of 675 Singaporean Chinese. Factor analysis showed that the factor structure of the English version CPAI was similar to the structure of the original Chinese version in the normative sample. Joint factor analysis of the English version CPAI and the NEO-FFI showed that the Interpersonal Relatedness factor of the CPAI was not covered by the NEO-FFI, whereas the Openness domain of the NEO-FFI was not covered by the CPAI. In Study 2, the English version CPAI was administered to a Caucasian American sample. The factor structure was similar to those of the Singaporean sample and Chinese normative sample. The implications of administering the CPAI in non-Chinese cultures are discussed.

Validity Ofvertical and Horizontal Individualism and Collectivism in Singapore Relationships with Values and Interests

The cross-cultural construct validity of vertical and horizontal individualism (VI and HI) and horizontal and vertical collectivism (HC and VC) at the individual level of analysis is examined across 180 U.S. and 184 Singapore students. The findings showed that the four-factor structure was invariant for a 16-item attitudinal measure (although one item did not fit well), the U.S. students were more HI and the Singapore students were more VC, and the constructs had culture-general and culture-specific associations with values and interests. Although the cross-cultural validity of the structure and individualism-collectivism dimension of the constructs were supported, the precision of the operationalization of the vertical-horizontal dimension by the 16-item measure is called into question because the expected correlations were not found.

Construct Validity of Career Indecision: Negative Personality Traits as Predictors of Career Indecision

The purpose of the present study was to evaluate the construct validity of career indecision by examining its relationships to selected negative personality traits (perfectionism, self-consciousness, and fear of commitment) among 217 college students. It was hypothesized that career indecision would be positively and significantly associated with perfectionism, self-consciousness, and fear of commitment. As predicted, fear of commitment was a strong predictor of career indecision. Two of the three dimensions of perfectionism were also predictive of career indecision: Self-oriented perfectionism was a significant negative predictor of career indecision, whereas socially prescribed perfectionism was positively predictive of career indecision. However, other-oriented perfectionism was not predictive of career indecision. As was true of perfectionism, two of the three dimensions of self-consciousness were predictive of career indecision: Private self-consciousness was a positive predictor of career indecision, and social anxiety was a negative predictor. Public self-consciousness was not a significant predictor of career indecision. The implications of the findings for career counselors and for future research are discussed.

Estimates of psychological distress among Vietnamese refugees: adolescents, unaccompanied minors and young adults.

This study focuses on the assessment of psychological distress among three subgroups of Vietnamese refugee youth: adolescents, unaccompanied minors, and young adults. Using translated and backtranslated instruments, data was gathered in refugee camps in the Philippines in order to provide baseline measurement for future comparisons, as well as to begin to develop normative standards for these populations. A rationale for the choice of instruments (Vietnamese Depression Scale, Hopkins Symptom Checklist-25 and General Health Questionnaire) is offered and mean scores and percentages scoring above established clinical cut-offs are presented. Results indicate relatively high levels of depression and anxiety for the young adult group, although anxiety appeared high across all three groups. All three groups also scored poorly on self-reports of general health, with the young adults and unaccompanied minors being especially overrepresented in the clinical range. Significant method problems were noted regarding construct validity in the assessment of depression, and instructional set differences that may account for the relatively low intercorrelations between seemingly similar measures.