QPA – Dr. Vivi Hua – Tx Chinese Patients 101815
Download
Report
Transcript QPA – Dr. Vivi Hua – Tx Chinese Patients 101815
Working with Chinese Immigrant
Individuals & Families in Psychotherapy
What Do You Need to Know?
Wei-Chun “Vivi” Hua, Psy.D.
Queens Psychological Association
10/18/2015
Outline
My background: cultural and professional
Background of Chinese immigrants in NYC
Major presenting issues of (undocumented) Chinese
immigrants
Cultural differences in therapy
My Cultural Background
• Country of origin
• Immigration
• Language
My Professional Background
• Gouverneur Healthcare Services
(NYCHHC)
• Early childhood center
• SCO Family of Services (foster care)
Chinese Immigrants in NYC
Older generations of Chinese immigrants
Cantonese-speaking
After 1980-1990s:
Fuzhou, Fujian Province of China
Fuzhounese, Mandarin-speaking
A large number w/o documentation
Primary population in local, social service agencies in
Chinese community
Major Presenting Issues
A sense of loss
Family & social network: source of support
Use of language
Identity: majority group → minority group
Power
Resources
Sense of belonging
The self is split
Major Presenting Issues (cont’d)
Acculturation/adjustment issues
Language
Food
Holidays
Transportation
Navigating new systems
School: parental rights, parent teacher conferences
Legal: “appropriate” parenting
Medical
Common Clinical Symptoms
Depression: sleep problems, loss of appetite
Anxiety: heart palpitations, shortness of breath
Anger, explosive behavior
Psychosomatic symptoms
Undocumented Chinese Immigrants
Late teens and early 20s
No or limited work experience
Experience of stressors on multiple levels
First time away from home
Traumatic, circuitous migratory journey
Dependent → provider of the family
Huge debts to pay off
Development of psychopathology
Limited access to healthcare
Psychiatric hospitalizations
Stigma about Therapy
Therapy is a foreign concept
Therapy is for “crazy” people!
They come to therapy because they “have to”
Utilization of:
Family or social network
Fortune-telling
Religion, spirituality: pray, karma, vegetarian diet
Western Society Based Therapy
Much value on info from the client
Thoughts and feelings
Inner conflicts
Early life history/stories
Cultural Differences in Therapy
Expressions
Verbal
Feelings and emotions are not a typical part of daily
language
Not as consciously and verbally in tune with their
feelings
Catch the moment, pause, and ask: What just came
to your mind?
Reflect that:You look sad, angry, confused, etc
Cultural Differences in Therapy
(cont’d)
Nonverbal
Gives out more info than verbal
Eye contact
Head-nodding: attention, not necessarily
agreement
Matching of affect
Pay attention to nuances in their facial,
nonverbal expressions
Cultural Differences in Therapy (cont’d)
Pragmatic orientation
Focus on the present and problem-solving:
Education
Job
Benefits, resources, etc
Daily living: transportation, family activities, etc
Cultural Differences in Therapy (cont’d)
Respect for hierarchy/professionals
Professional status and title
Dr./Ms./Mr. vs. first names
Teacher – student dynamics
Directive vs. exploratory
Learning, psychoeducation
Specific goals, homework
Little questioning: frame-setting
Chinese Families
Children
Extensions of their parents and family
Their success/failure matters to the family
Know his/her role and obligations within the family
Parents
Life purpose: to help their children succeed
Self-sacrifice
Chinese Immigrant Families
Intergenerational conflicts
Immigrant parents
vs. Children born or came here when little
Generational differences
Traditional Chinese values
vs. American values
Conflicts often arise when:
Decline in academic performance
Change in behavior: stay out late, makeup, clothing, smoking,...
Involvement in a romantic relationship as adolescents
Chinese Immigrant Families
A case
Child:16 yo Chinese -American female
Mother: immigrated to the U.S. in her late 20’s
Involvement w ACS
In therapy:
Validate their different values
Help them understand each other’s perspective
Facilitate communication
How to move forward? What are absolutely important
for each of them?
Contact Information
Wei-Chun “Vivi” Hua, Psy.D.
[email protected]