Family Therapy

Asian families’ philosophy of life, irrespective of country of origin, emphasises children’s hierarchical deference and obligation to the family, including extended family. Conversely, western philosophy emphasises individualism and personal growth through separation and individuation from the family of orientation.

Given the core differences between the egalitarian orientation of western cultures and the collectivistic orientation of Asian families, there are discrepancies between European therapists and Asian families with regard to their worldview and priorities for parenting. For example, in working with families experiencing intergenerational difficulties many therapists discover that their value orientation towards differentiation and independence of adolescents and young adults often conflicts with parents’ traditional values of familism that demands unqualified deference to parents and extended family, and is usually equated with family loyalty. Consequently, European therapists’ who attempt to either outright replace or move too quickly to have Asian families modify their values will be ineffective. If these differences are not addressed in therapy, there is an increased likelihood that both the therapist and family could experience frustration, which could contribute to the family’s premature termination from therapy.

Traditionally, within Asian cultures, families are patriarchal, and women’s roles, other than motherhood, are not accorded the same importance as men and their roles. Consequently, although some Asian families emigrated from countries (eg, South Africa) in which women function in professional roles such as physicians and lawyers, many family members, especially males, regardless of age and education, tend to be uncomfortable with women as professional psychotherapists. Consequently, despite a female therapist’s skills and training, the family may in all likelihood, reject her as a therapist, because of her gender. On occasion, even adolescents, males as well as females, may also reject the female therapist’s help or more importantly sabotage her therapeutic efforts. Similarly, female therapists, feminist oriented therapists in particular, who may attempt to bond or establish sisterly rapport with female family members may be discouraged by the females’ lukewarm reception, and rejected by the males who often view such joining as a threat to the family’s collectivist values.

Therapy with any client tends be most effective when therapists share similar group membership to those of their client because such similarity enhances the therapists’ credibility. In this context, credibility refers to a family’s perception of the therapist as an effective and trustworthy helper. Working with any family’s system, especially a family from a different membership group than the therapists own, therapist’s are confronted with two kinds of credibility - ascribed and achieved. Ascribed credibility refers to the therapist’s knowledge of the cultural background, including values, norms, and lifestyles, for example, of the family, and is assigned by the family to the therapist. Achieved credibility refers to the therapist’s clinical skills. Because western therapists and Asian families do not share a similar membership cultural group, Asian families may perceive such therapists to be lacking the necessary ascribed credibility (as determined by the particular family), and may be hesitant or even resistant to engage in therapy with such therapists. Consequently, it is important that western therapists maximise their ascribed credibility to enhance the family’s perception of them as trustworthy and effective helpers.

Western therapists’ lack of credibility with Asian parents because of cultural differences, can often contribute to the therapist feeling therapeutically impotent in his or her efforts to effect change in the family’s system. For example, therapists who use their achieved credibility (ie, clinical skills) to encourage an Asian wife or child to confront the husband/father in therapy may find both the wife and the child resistant to doing so, because of the discordance of the suggestion with the family’s traditional cultural norms for husband-wife and parent-child relationships. By so doing the therapist’s achieved credibility is diminished and he/she becomes impotent as a change agent. Because of the incompatibility of the therapist’s suggestion with the family’s cultural values, not only does the wife resist acting upon it, she may ally with the husband/father against the therapist, making intervention futile. Such resistance can negatively affect the therapeutic process, contribute to premature termination of the family from therapy or worse, the family politely remains in therapy but does not change its behaviours.