Working with Culture: Psychiatric and Mental Health Care Providers' Perspectives on Practice with Asian American Families

The purposes of this hermeneutic phenomenological study were to 1) understand Asian American families' everyday caregiving practices for a person with mental illness and 2) understand how mental health care providers provide care for AA patients and families. AA was defined as immigrants from Korea, China, and Japan and their descendents. The specific aims were to 1) examine patterns of family caregiving practices for mentally ill family members among AA families as observed by mental health care providers 2) provide a systematic articulation of Confucianism as manifested in the AA family caregiving practices and describe how Confucianism is modified as families acculturate to the United States, 3) identify the particular difficulties perceived by mental health care providers and some strategies they use to cope with these difficulties, and 4) examine patterns of practice among mental health professional providing care for AA patients and families. Participants were comprised of twenty providers who have treated mentally ill AA patients and families in the past 5 years in the San Francisco Bay Area. Data were collected through fact-to-face, in-depth interviews. In addition, field notes and memos were also included in the analysis.Study findings are consistent with the current knowledge of strong family supports in the AA population. However, the study findings emphasize that AA family caregiving practices should be understood in a much more complex manner. The study findings also highlight that a strong Confucian emphases on the family is still present among AA families, particularly in issues around caregiving and communication among family members.Narratives from practitioners illustrate the clinical reality of cultural competency and describe providers' practices when caring for mentally ill AA patients and their families. Such detailed illustrations provide insight for novice practitioners or those who have limited opportunity to work with this population. The findings of this study support some current guidelines while challenging others. For example, the emphasis on short-term result oriented solutions was problematized because it ignored the chronic nature of mental illness. This study found that providers had to cover broader and more complicated material in psychoeducation for AAs than current literature recommended