Working with Chinese Immigrant
Individuals & Families in Psychotherapy
What Do You Need to Know?
Wei-Chun “Vivi” Hua, Psy.D.
Queens Psychological Association
10/18/2015
Outline
 My background: cultural and professional
 Background of Chinese immigrants in NYC
 Major presenting issues of (undocumented) Chinese
immigrants
 Cultural differences in therapy
My Cultural Background
• Country of origin
• Immigration
• Language
My Professional Background
• Gouverneur Healthcare Services
(NYCHHC)
• Early childhood center
• SCO Family of Services (foster care)
Chinese Immigrants in NYC
 Older generations of Chinese immigrants
 Cantonese-speaking
 After 1980-1990s:
 Fuzhou, Fujian Province of China
 Fuzhounese, Mandarin-speaking
 A large number w/o documentation
 Primary population in local, social service agencies in
Chinese community
Major Presenting Issues
 A sense of loss
 Family & social network: source of support
 Use of language
 Identity: majority group → minority group
 Power
 Resources
 Sense of belonging
 The self is split
Major Presenting Issues (cont’d)
 Acculturation/adjustment issues
 Language
 Food
 Holidays
 Transportation
 Navigating new systems
 School: parental rights, parent teacher conferences
 Legal: “appropriate” parenting
 Medical
Common Clinical Symptoms
 Depression: sleep problems, loss of appetite
 Anxiety: heart palpitations, shortness of breath
 Anger, explosive behavior
 Psychosomatic symptoms
Undocumented Chinese Immigrants
 Late teens and early 20s
 No or limited work experience
 Experience of stressors on multiple levels
 First time away from home
 Traumatic, circuitous migratory journey
 Dependent → provider of the family
 Huge debts to pay off
 Development of psychopathology
 Limited access to healthcare
 Psychiatric hospitalizations
Stigma about Therapy
 Therapy is a foreign concept
 Therapy is for “crazy” people!
 They come to therapy because they “have to”
 Utilization of:
 Family or social network
 Fortune-telling
 Religion, spirituality: pray, karma, vegetarian diet
Western Society Based Therapy
 Much value on info from the client
 Thoughts and feelings
 Inner conflicts
 Early life history/stories
Cultural Differences in Therapy
 Expressions
 Verbal
 Feelings and emotions are not a typical part of daily
language
 Not as consciously and verbally in tune with their
feelings
 Catch the moment, pause, and ask: What just came
to your mind?
 Reflect that:You look sad, angry, confused, etc
Cultural Differences in Therapy
(cont’d)
 Nonverbal
 Gives out more info than verbal
 Eye contact
 Head-nodding: attention, not necessarily
agreement
 Matching of affect
 Pay attention to nuances in their facial,
nonverbal expressions
Cultural Differences in Therapy (cont’d)
 Pragmatic orientation
 Focus on the present and problem-solving:
 Education
 Job
 Benefits, resources, etc
 Daily living: transportation, family activities, etc
Cultural Differences in Therapy (cont’d)
 Respect for hierarchy/professionals
 Professional status and title
 Dr./Ms./Mr. vs. first names
 Teacher – student dynamics
 Directive vs. exploratory
 Learning, psychoeducation
 Specific goals, homework
 Little questioning: frame-setting
Chinese Families
 Children
 Extensions of their parents and family
 Their success/failure matters to the family
 Know his/her role and obligations within the family
 Parents
 Life purpose: to help their children succeed
 Self-sacrifice
Chinese Immigrant Families
 Intergenerational conflicts
 Immigrant parents
vs. Children born or came here when little
 Generational differences
 Traditional Chinese values
vs. American values
 Conflicts often arise when:
 Decline in academic performance
 Change in behavior: stay out late, makeup, clothing, smoking,...
 Involvement in a romantic relationship as adolescents
Chinese Immigrant Families
 A case
 Child:16 yo Chinese -American female
Mother: immigrated to the U.S. in her late 20’s
 Involvement w ACS
 In therapy:
 Validate their different values
 Help them understand each other’s perspective
 Facilitate communication
 How to move forward? What are absolutely important
for each of them?
Contact Information
Wei-Chun “Vivi” Hua, Psy.D.
vivihua06@gmail.com