Conclusion

Many CALD families attempt to deal with their psychological problems without seeking professional services and tend to rely on the family in dealing with their problems. Many come to mental health professionals as the last resort. There is increasing evidence to suggest that treating clients and families in a more culturally sensitive manner can reduce treatment failure. Without culturally appropriate and linguistically compatible services there is the potential for misdiagnosis. Cultural presentations of distress and culture-bound syndromes may not fit within western normed diagnostic categories. The DSM-V offers an adaptive interview technique (the Cultural Formulation of Diagnosis) to compensate for the cultural insensitivity of diagnostic instruments. Due to Asian, Middle Eastern and African traditions of viewing the body and mind as unitary rather than dualistic, clients tend to focus more on physical than emotional symptoms, leading to an overrepresentation of somatic complaints.

CALD clients and families respond well to highly structured psychosocial interventions such as those used in behavioural, cognitive, and interpersonal models. When applying pharmacotherapy, clinicians should pay attention to Asian and African unique responses to psychotropics, especially in regard to dosage requirements and side effects.

Although it is necessary to emphasise the heterogeneity of Asian and other ethnic minority groups, it is equally important to acknowledge a certain level of cultural similarity among them. For example, Asian families place a high value on collectivist family values rather than the individual. The individual is seen as the product of all the generations of his or her family. Because of this continuum, an individual's personal action reflects not only on himself/herself but also on his/her extended family and ancestors. An individual is expected to function in his or her clearly defined roles and positions in the family hierarchy, based on age, gender, and social class. Obligations and shame are the mechanisms that traditionally help to reinforce societal expectations and proper behaviour. There is an emphasis on harmonious interpersonal relationships, interdependence, and mutual obligations or loyalty to family. 

Most parents demand respect and obedience from their children. In many extended families, children are not solely raised by their parents but are cared for by a wide range of adults (grandparents, uncles, aunts, cousins). Traditional Asian cultures avoid open conflict. Family conflict is frequently managed by role segregation, indirect communication, and polite inattention. The strong hierarchy within the family defines who may voice an opinion and who must suppress it.

Increasingly, Asian migrant parents and their children are being referred for family therapy because of parent-child conflicts. Many of the problems parents and children bring to therapy result from intergenerational relationship strains, and the adolescent, or young adult separation-individuation occurring in an unfamiliar context under different cultural rules. To be clinically effective therapists need to be knowledgeable about Asian/MEA family values, norms, and traditions, be flexible in their psychosocial approaches, and create an atmosphere in which both parents and children feel valued and respected.