Guidelines for Adapting Structural Family Therapy Approach for Immigrant Generation East Asian American Families

The author developed detailed guidelines for adapting the structural family therapy approach for therapists who work with immigrant east Asian American families. Due to different acculturation levels among family members, immigrant parents often have conflicts with their children, which have become an important reason why Asian American families seek mental health services. The review of both traditional east Asian familyrelated cultural values and European American cultural values illustrates the parenting emphases that vary to a great extent between these two broad cultural groups. The widely accepted child development theories, parenting theories, and family therapy approaches were developed primarily based on European American populations. Asian American parenting approaches are often regarded as less favorable when they are evaluated using the Western parenting standards. However, many studies indicated that the traditional Asian American parenting approaches, including the parents’ emphasis on respect for elders, interdependency, self-control, and education, did not impact the children negatively. Studies suggested reduced treatment effectiveness when therapists treat east Asian families using Western developed family therapy approaches, such as structural family therapy, without adaption. The author adapted each structural family therapy technique for immigrant east Asian family by incorporating their traditional parenting values into the standard techniques. ADAPTED STRUCTURAL FAMILY THERAPY FOR ASIAN AMERICANS 3 Introduction Many studies (Fuligni, Tseng, & Lam, 1999; Juang, Cookston, Wang, & Kim, 2012; Phinney, Ong, & Madden, 2000) have indicated a significant discrepancy between immigrant generation east Asian parents’ perception and their US-born teenagers’ perception of parent-child relationships. For example, Asian American parents rated a higher level of warmth in their relationship with children, but the Asian American teenagers rated a lower level of warmth (Padmawidjaja & Chao, 2010). This difference in perspectives often leads to conflicts between parents and children, which has been a consistent focus of family therapy for east Asian Americans. Family cultural conflicts have been shown to be a significant predictor of mental health service utilization among east Asian Americans (Lee & Yoshida, 2005). The current predominant family therapy approaches were developed based on Western cultures. Many of the Western parenting concepts are counterintuitive to many immigrant generation east Asian American parents due to their emphasis on interdependence, whereas independence is stressed in white American culture (Bornstein, 2005). Without parents’ cooperation, it is more likely that there will be poor treatment adherence. Thus, it is important to understand east Asian parents’ beliefs about parenting and incorporate their beliefs into the current family therapy models. The goal of this paper is to provide specific guidelines for how to incorporate east Asian parents’ beliefs into structural family therapy. The paper will focus on parents who immigrated from the east Asian countries of China, Japan, and South Korea, since these three countries’ parenting beliefs and family related cultural values are very similar to each other and are heavily influenced by Confucian ideology (Bornstein, 2005). In addition, ADAPTED STRUCTURAL FAMILY THERAPY FOR ASIAN AMERICANS 4 given the large differences between other Asian countries’s cultural backgrounds, such as India or Thailand, and east Asian cultures, it will very difficult to discuss and adapt structural family therapy for every Asian country. I will describe the primary traditional family related values, which are the foundation of east Asian American parenting approaches. To contrast, I will also review the cultural foundations of traditional European American parenting. Although there are variations among the four predominant white American ethnic groups, including German Americans, Anglo Americans, Irish Americans, and Italian Americans, their descendants have lived in the U.S. for several generations and their cultural values have become very similar to each other (Hess, & Hess, 2001). Many of them tend to identify themselves as “white American” (Alba, 1990). I will introduce the consistently identified cultural values that characterize white American culture. Each value affects European American parenting beliefs, child development theories, and child rearing approaches (Hess, & Hess, 2001). I will also compare and contrast the parenting differences between these two broad cultural groups. I have chosen to focus on adapting Minuchin’s structural family theory because it “is the most influential approach to family therapy throughout the world” (Nichols, 2012, pp123). I will review major structural family therapy techniques and discuss the compatibility of these techniques when applied to east Asian American families. Most important, I will discuss how to adapt each technique to east Asian American families. Traditional East Asian Cultural Values The Confucian ideology and collectivism are deeply embedded in east Asian parenting beliefs and have shaped the east Asian parents’ emphasis on (a) filial piety and ADAPTED STRUCTURAL FAMILY THERAPY FOR ASIAN AMERICANS 5 interdependency among family members, (b) self-control, and (c) the importance of education. These three parenting emphases have been consistently identified across my three specified east Asian countries (Kim & Wolpin, 2008; Kim, 2009; Sakamoto, Kim, & Takei, 2012). Filial Piety and Interdependency Although today east Asian parents do not actively teach children Confucian doctrines, Confucian ethics are still deeply imbedded in their daily lives and their interactions with children (Wu, 2001). Confucian philosophers defined five key hierarchal relationships, one of which is children’s obedience and respect of parents. Confucians regard children’s reverence to parents as filial piety. Confucians believe that since children’s bodies originated from their parents, this places parents in an authoritative and superior position, and thus children are required to follow their lead. Confucians also consider filial piety as a primary code of conduct, and the concept of filial piety still pervades in Chinese, Japanese, and Korean society (Kim & Wolpin, 2008; Shibusawa, 2001; Wu, 2001). Confucianism is an important part of the foundation of collectivistic cultures. In individualistic cultures, the individual is perceived as a separate entity with a unique personal identity. However, Confucians consider a family as “a whole person,” such that “each role in the family represents a distinct part of the human body, and together they constitute an inseparable entity” (Hwang, 1999, p. 170). In other words, each family member is in an interdependent relationship with each other. Family members rely on each other to meet their personal needs, and are expected to prioritize the needs of the whole family instead of personal needs. Rhee, Uleman, and Lee (1996) suggested that in relation ADAPTED STRUCTURAL FAMILY THERAPY FOR ASIAN AMERICANS 6 to their families, Koreans tend to emphasize interdependence and prioritize the “in-group goals” over personal goals compared to European Americans, although there was no difference found between Koreans and European American in relation to non-family members. Self-Control In Confucian societies, the practices of impulse control and self-monitoring are highly stressed and are considered preconditions for success and achievement (Ho, 1994). Self-control skills refer to the abilities to monitor desires, wants, emotions, and behaviors, thereby acting congruently with social and moral standards. Starting in early childhood, children in east Asian cultures are trained to behave properly without violating social norms and showing negative emotions (Kim, & Wong, 2002). For example, in social gatherings children are expected to take what they are offered by adults, and the behavior of asking for what they want is considered as being impolite and childish. The Importance of Education The Confucians believed that seeking knowledge is a lifelong and holistic pursuit. Furthermore, learning is a process of seeking self-cultivation and self-improvement for the sake of guiding one’s social conduct and passing on knowledge for the benefit of the society (Bornstein, 2005; Kim, 2009). In east Asian cultures, the early stage of cultivation is considered as an essential part of one’s development, and children are perceived as “white papers,” suggesting their innocence, lack of knowledge, and innate goodness. The job of making sure that children learn under proper influence and grow in the right direction is the responsibility of parents (Bornstein, 2005). Japanese parents consider child-rearing as the process of helping children cross a river from one side to another, and parents need ADAPTED STRUCTURAL FAMILY THERAPY FOR ASIAN AMERICANS 7 to walk along with them to provide necessary assistance, emotional support, and help them avoid potential risks (Chao, 1996). East Asian parents consider education the primary method to obtain success. Their emphasis on academic accomplishment is higher than parents from European American parents (Chao, 1996; Kim, Im, Nahm, & Hong, 2012; Sakamoto, Kim, & Takei, 2012). Fuligni (1997) measured the relative impact of parental attitudes on the academic achievement of students with East Asian, European, Filipino, and Latino backgrounds. The reports from the students indicated that East Asian and Filipino parents had higher parental expectation and aspirations than parents with Latino and European backgrounds. Traditional European American Values and Their Impact Despite the differences of parenting practices among the four main European American ethnic groups (i.e., German, Anglo, Irish, and Italian), the commonly identified norms and values characterizing white Amer