Yuhwa Eva Lu

Asian Americans and Mental Health Services

Abstract Research in the 1970s and 1980s revealed that Asian Americans, compared with other ethnic groups, tended to under-utilize mental health services. This article is aimed at adding new information to the literature by examining data from the 1990s. The raw data comprised 97,212 total admissions representing 45,774 total individuals utilizing mental health services during a four-year period in San Diego County, California. By comparing our findings with previous research cases on utilization patterns of mental health services, new evidence is found about Asian Americans in terms of their (1) underrepresentation in mental health services, (2) presentation of more severe symptoms than those of other racial/ethnic groups when first seen at clinics, (3) lower dropout rates and higher average lengths of stay than other racial/ethnic groups, and (4) higher percentages of using day treatment and outpatient programs but lower percentage of using inpatient programs.

A New Methodology for Assessing Social Work Practice: The Adaptation of the Objective Structured Clinical Evaluation (SW-OSCE)

The Objective Structured Clinical Evaluation (OSCE) methodology was originally developed to assess medical students. OSCE is a carefully scripted, standardized, simulated interview, in which students’ interactional skills are observed and assessed. Here it is examined for its potential use in assessing social work practice skills. The development of the Social Work OSCE (SW-OSCE) and the Clinical Competence-based Behavioural Checklist (CCBC) are described. Findings from a pilot study assessing MSW students’ clinical skills with explicit observable criteria of the CCBC are presented. A quantitative and qualitative mixed-methods data analysis was applied. The CCBC had high internal reliability, for both the overall sample and for the different case scenarios, with Cronbachs alpha values ranging from 0.888 to 0.965. The validity of the instrument was also examined: qualitative content analysis of the taped interviews indicated that clinical skills and cultural empathy are not synonymous. The racial/ethnic match between the student and the ‘client’ did not predict better rapport or more cultural empathy. Examination grades are not necessarily consistent with actual performance in either clinical competence or cultural empathy or vice versa. Nevertheless, the results provide some support for the use of the SW-OSCE as a tool for assessing performance in social work practice. They also indicate its potential for evaluating the outcomes of educational programmes.

An Experiential Model

Abstract This article examines the effects of a pilot project for an experiential instructional model in teaching culturally sensitive, empathic communication skills. It attempts to integrate and communicate the theoretical, conceptual, and experiential understanding of cross-cultural empathy through the practice of mindful attitudes. Students were introduced to materials through a series of exercises which included mirroring breathing observation, posture, and moving awareness. These exercises fostered a state of openness through the experience of emptying, contemplation, and being-present. The preliminary findings indicate that the students were able to verbalize new learning experiences which included: being more attuned withtheirbodilyawareness, sensing theflow of energy with the other, letting go of power struggles, and pre-existing ideas, and experiencing a different kind of human connectedness with the other.

Exploring Dimensions of Culturally Sensitive Clinical Styles with Latinos

Abstract This study sought to identify dimensions of culturally sensitive clinical practice by comparing the personal clinical styles of Latino and non-Latino clinicians, and their clinical decisions in respect to Latino immigrant clients. A combination of qualitative and quantitative methods were used. Sixty Latino American clinicians and 47 non-Latino (White) clinicians in Northern California completed the Achieving Styles Inventory (ASI) which yields information on direct, instrumental and relational styles. Demographic data were obtained as well as information on language proficiency and years of clinical experience. Statistical analysis included uses of t-test, ANOVA, and multiple regression analysis and revealed significant differences between the two groups in personal achieving styles within all three domains. There were no significant differences on the demographic variables. Nine clinician members of each ethnic group were interviewed in-depth through non-directive interviewing styles to assess their clinical decision making via use of a case vignette. Content analysis pointed to similarities and differences in proposed assessment and intervention strategies. The Latino group displayed more culturally relevant interpretations. The non-Latino clinicians were more directive and instrumental than the Latinos who put more emphasis on self disclosure, case management, use of Spanish with the client, and crisis intervention. This finding is consistent with both the quantitative data analysis of ASI hypotheses and the expected linguistic/cultural findings of the qualitative content analysis. Bilingual non-Latino White clinicians showed more cultural sensitivity and competence than the monolingual non-Latino clinicians. These findings suggest that linguistic/cultural match and linguistic/cultural compatibility are important in cross-cultural clinical practice.