In the realm of mental health care, the decision to seek therapy can be a pivotal step towards healing and self-discovery. However, for many Asian Americans, this journey often meets an abrupt end before it even begins. Statistics reveal a staggering truth: one-third of Asian Americans drop out of therapy before attending an intake session, and those who do start are likely to terminate prematurely. This reality prompts a critical examination of the barriers that hinder Asian Americans from fully engaging with talk therapy, as well as the necessary steps to foster a more inclusive and culturally sensitive therapeutic environment.
Cultural Factors
The decision to discontinue therapy among Asian Americans stems from a complex interplay of cultural, societal, and personal factors. Deep-rooted cultural stigmas surrounding mental health persist within many Asian communities, often viewing psychological struggles as a sign of weakness or personal failure. Consequently, seeking therapy may be perceived as an admission of inadequacy, leading to feelings of shame and reluctance to disclose one’s innermost struggles. This can lead to an extended amount of time in therapy compared to other ethnic groups in order to see the best progress. Asian American clients may feel frustrated and embarrassed that therapy isn’t “working” the way they expected. That is far from the truth, as they are combatting deeply held narratives about being able to bring honor to their family and their own life accomplishments by toughing it out on their own. Building a framework for wellness that deconstructs those narratives can take a long time.
Additionally, disclosing about problems within the family or childhood is frowned upon in most non-Western cultures. Honoring one’s parents and broader family is a cultural value. Despite promises of confidentiality from the therapist, the client’s family and client could still perceive disclosing during the session as losing face and bringing dishonor to the family. Asian American immigrants see status as a way to combat the very real racism that they face as a non-white ethnic group. To begin disclosing, especially about familial relationships, is a direct contradiction to survival as a minority in the United States. This can only intensify around families that have upheld abuse in any way. Upholding abuse is a common practice of many American families. However, in immigrant families, it can have the additional weight of betraying one’s family when the rest of the country perceives them in a certain way. This can cause especially female clients to prematurely leave therapy, seeing their disclosure as an abandonment of their role as the nurturing protector in their family. Setting boundaries or calling out abuse can result in the client getting punished by their family through disownment, disapproval, or other deeply painful methods of excluding the client from the family. Upholding family roles is vitally important, and therapists need to understand the weight of navigating these situations for their client.
Moreover, the Westernized approach to therapy, which often prioritizes verbal expression and introspection, may not resonate with Asian Americans who come from cultures that value collectivism and interdependence. In many Eastern cultures, emotions are often expressed implicitly through actions and behaviors rather than through explicit verbal communication. Therefore, the emphasis on talk therapy as the primary mode of treatment may feel foreign and ineffective to Asian Americans, leading to disengagement and premature termination. It also emphasizes the individual over the family relationships that sustain the client’s culture and values. This lack of cultural competence among therapists exacerbates the challenges faced by Asian Americans in therapy. Many Asian Americans report feeling misunderstood or invalidated by their therapists, who may lack awareness of their cultural background and unique experiences. The burden of educating therapists about cultural nuances and sensitivities should not fall on the clients’ shoulders; instead, therapists must proactively educate themselves and cultivate cultural humility to better serve their diverse clientele.
What Practitioners Can Do
So, what can practitioners do to bridge the gap and create a more inclusive therapeutic environment for Asian Americans? Firstly, increasing diversity within the mental health profession is crucial. By recruiting and retaining more Asian American therapists, clients are more likely to find providers who understand their cultural context and can provide culturally competent care. Additionally, training programs should incorporate cultural competency training that addresses the specific needs and challenges faced by Asian American clients. Furthermore, therapists must be open to integrating Eastern methods of healing into their practice. While talk therapy has its merits, it is not the only path to healing. Eastern approaches such as mindfulness, meditation, and holistic wellness practices offer valuable tools for addressing mental health concerns and promoting overall well-being. By embracing a more holistic and culturally sensitive approach to therapy, practitioners can create a space where Asian Americans feel seen, heard, and understood. Giving voice to Asian American practitioners can ensure that this movement remains culturally competent and Asian centered. Read this article to learn more about broader healing modalities: Talk therapy falls short for many Asian Americans. They’ve turned to centuries-old alternatives. (nbcnews.com)
At WOC Therapy, we are committed to expanding how we view wellness to address this discrepancy. Our attention to incorporating Ayahuasca ceremonies, yoga, energy healing, and communal practice points to the value of seeing healing as a communal effort, tied to various experiences that come from varying ages and ethnicities. Talk therapy alone cannot solve mental health complications. Individuals need to be plugged into community that supports and uplifts them. Self-disclosure and vulnerability can come easier if the client is surrounded by others committed to healing, especially combining that mental healing with physical healing. To learn more, contact us here: Reach Out for Support | Contact Us | WOC Therapy
It’s important to recognize that the reluctance to engage with talk therapy does not stem from a lack of desire for healing or self-improvement. Instead, it reflects a systemic failure to provide culturally competent and accessible mental health care to Asian American communities. Asian Americans should not be discouraged from seeking therapy; rather, they deserve a therapeutic environment that honors their cultural identities and values. Therapy began as a Western modality that did not create space or recognize the wisdom of healing traditions that came long before. Because of this, it is up to practitioners to continue challenging the strictly Western approach and incorporating other methods to make space for everyone in therapy. Talking is not the end all, be all, or healing. We exist as whole bodies that are connected to other people, and our healing needs to reflect that. Practitioners can also pay attention to cultural values like elder respect, avoiding direct confrontation, and any other options to incorporate the client’s culture.
In conclusion, addressing the disparities in mental health care for Asian Americans requires a multifaceted approach that encompasses systemic changes within the mental health profession, increased cultural competency among therapists, and a broader recognition of diverse healing modalities. By working together to dismantle barriers and foster inclusivity, we can create a future where all individuals, regardless of cultural background, have access to the care and support they need to thrive.