Underutilization of mental health services by Asian American clients: The impact of language and culture in clinical assessment and intervention

Previous research indicates a disproportionately low service utilization rate and a high dropout rate among Asian Americans receiving mental health services. Findings suggest that many of the factors accounting for this problem are related to cultural and linguistic mismatches. This study asked the following questions: Do non-Asian American and Asian American clinicians differ in their (1) style of service delivery, (2) assessment of their Asian American clients, and (3) interventions with them? Clinicians' clinical assessment and intervention strategies are identified components of this study. Eight in-depth interviews were conducted with Asian American and non-Asian American clinicians in the field of social work. A case vignette was developed as the basis for the interviews. Data analysis was based on a content-analysis approach. The findings showed clinicians from the Asian American group as more process-oriented: they placed more emphasis on use of non-directive intervention styles, family dynamics, and level of acculturation. They assessed the case as being less severe, predicting a better prognosis than did the non-Asian American clinicians. Family unity was an identified goal, and there was a strong emphasis on rapport-building in the initial session. In comparison, the non-Asian American clinicians were more content-oriented. They placed more emphasis on individual member's clinical assessments, symptom reduction, individual goal-setting, autonomy, and separation/individual issues. They assessed the case as more severe and predicted a poorer prognosis.