Reality therapy and the Asian American Client

A study conducted by Tsai-Chae and Nagata (2008) found that “immigrant families from traditional Asian backgrounds can experience greater family dysfunction than other ethnic minority groups,” (p.205). Additionally, the majority of these conflicts arise during adulthood and in comparison to European American adolescents the “levels of family conflict were significantly higher among Asian American college students,” (p.305). These intergenerational conflicts, which arise during adulthood, have been positively correlated with psychological problems such as anxiety and depression “and Asian American students who enter counseling frequently attribute their psychological distress to relationships with their parents,” (p.305). While the counselor may be initially concerned about an Asian client’s reluctance to “open-up” and discuss the root of his or her issues, it is important to note that, in general, Asians Americans tend to under utilize mental health services and “recent reports indicate that less than 6% of Asian Americans with a psychological problem sought assistance,” (Hsu & Alden, 315). Of those Asian Americans who do seek the assistance of a mental health professional tend to do so only after there is a persistent and excessive somatic or behavior symptom of their emotional distress (Hsu & Alden, 2008). Asian clients often express a desire to honor their parents and a fear of causing them shame, this value is founded in the Asian belief that family members share a single sense of identity and responsibility to each other, therefore the client’s behaviors are not just representative of themselves but of their family as a whole. In acknowledging this value, one could assume that a client’s hesitance to talk with the therapist, would be founded in the belief that “the burden of the stigma of mental illness not only falls on the afflicted individual but also on all family members,” (p.318). Therefore, a concern of bringing shame upon his or her family may be the basis for the client’s reluctance to admit to mental health problems.

Reality therapy, an approach founded by William Glasser, similar to that of Rational Emotive Behavioral Therapies (REBT) and has been shown effective when working with diverse clients. “Reality therapy explores the client’s values and behavioral choices, exposing inconsistencies and enforcing responsibility for those choices,” (Okun & Kantrowitz, 138). Those who subscribe to the Reality approach believe that, as humans, we alone, are responsible for our actions. Reality therapist’s propose that “human beings are motivated to change (1) when they determine that their current behavior is not getting them what they want and (2) when they believe they can choose other behaviors that will get them closer to what they want,” (Corey & Corey, 140). The goal of treatment utilizing this approach is to assist the client in satisfying their basic needs, i.e. “survival, love and belonging, power, freedom, and fun,” (p.140) thereby directing change to those behaviors which inhibit that fulfillment of these needs. Regardless of which method one may chose, the overall goal is to treat the client’s emotional and physical disturbances. Reality therapy would focus on negative effects of the client’s current choice of actions and assist him or her in finding more appropriative constructive behaviors which would encourage a balance between their own needs and values and that of their family.

Currently this writer finds herself most aligned herself with Reality therapy. As she has explored this method, and has read descriptions depicting Reality therapy in practice, and finds great benefit in this approach's belief that; to get better or be "treated" one must recognize and change those behaviors that are self-defeating. Often times, she herself has heard the common-sense voice of Dr. Phil ringing through her head, “Is it working for you?” and finds great value in this approach. When working with guests who appear on his show experiencing emotional distress at the way events are playing out in their lives, Dr. Phil inquires about the action they have taken to alter these events. If he believes that their actions are self-defeating or fail to promote the positive response the guest desires, he simply suggests that their approach is not working and informs that they must change how they have been doing things, if they are to expect a different outcome. -“The definition of insanity – doing the same thing over and over, expecting a different result.”

Stephanie Henckel

References

Corey, M. S. & Corey, G. (2007). Becoming a helper (5th ed.). Thomson Brooks/Cole. Belmont, CA.

Hsu, L. & Alden, L. (2008). Cultural influences on willingness to seek treatment for social anxiety in Chinese- and European-heritage students. Cultural Diversity and Ethnic Minority Psychology, 14 (3), 215-223.

Okun, B. F. & Kantrowitz, R. E. (2008). Effective helping: Interviewing and counseling techniques (7th ed.) Thomson Brooks/Cole. Belmont, CA.

Tsai-Chae, A.H. & Nagat, D.K. (2008). Asian values and perceptions of intergenerational family conflict among Asian American students. Cultural Diversity and Ethnic Minority Psychology, 14(3), 205-214.