iwamasa, hsia, and hinton (U.S. Census Bureau, 2012). Asian Americans are the most likely of any racial or ethnic group to live in mixed-ethnic neighborhoods and marry across ethnic groups, with about 74% born abroad and 50% who speak English fluently (Pew Research Center, 2013).Despite this diversity, researchers often lump together Asians of diverse cultures, and as a result, the generalizability of these studies is limited (Pan, Huey, & Hernandez, 2011). Furthermore, participants in such studies are often English-speaking students attending U.S. universities-a group that is not representative of Asian Americans as a whole. Acknowledging these limitations, some researchers have identified similarities across Asian ethnic groups that can be useful to clinicians. In addition, awareness of the marked cultural, political, and environmental differences among and within groups may assist therapists in providing culturally competent treatment. However, it must be stressed that each culture, as well as each individual, has unique characteristics that have to be fully explored and understood; this chapter merely serves as a guide.In the United States, Asian Americans are often viewed homogenously as either a model minority (Gupta, Szymanski, & Leong, 2011;Kiang, Huynh, Cheah, Wang, & Yoshikawa, 2017) or "forever foreign" (Zhou, 2004). Unfortunately, both views work against the provision of culturally competent care. Assuming that a client is a model minority member can lead the therapist to overlook significant stressors, whereas viewing the client as forever foreign may cause the therapist to assume the client is incapable of healthy adaptations. Competent clinicians recognize the heterogeneity of Asian Americans, including differences related to language (i.e., preferred spoken language, fluency, multilingual abilities), religion and spirituality, gender roles, education and employment status, identity, generational status, and immigration history (including intergenerational experiences as refugees or immigrants).
HISTORICAL AND CULTURAL BACKGROUNDThe histories of many Asian countries overlap because of their proximity and mutual conquests. For example, part of the Japanese language is based on the Chinese language, and many still use the Asian lunar calendar. Some negative sentiment remains between some Asian countries because of past political conflicts (e.g., Japan and China) and current ones (e.g., North Korea and South Korea). Culturally competent care requires awareness of the potential for such histories to affect an Asian American client's perceptions, beliefs, and behaviors. A comprehensive review of the histories of specific Asian American cultures is beyond the scope of this chapter,Copyright American Psychological Association. Not for further distribution.cognitive behavior therapy with asian americans 131 and readers are encouraged to consult Hall and Okazaki (2002) and Leong et al. (2007).
ImmigrationSome Asian Americans, such as Japanese Americans, have been established in the United States for many g...