Structural Family Therapy for Asian Family - Research Paper Example

Structural Family Therapy for Asian Family I. Beginnings of Family Therapy         Marriage and family therapy as a profession is considered comparatively new, in relation to other fields of psychology. Its initiation can be traced to the late 1940’s and 1950’s. It is aptly called the foundation years. However, it was not until the 1970’s and 1980’s that it had major changes and movements for further development. For instance, Nathan Ackerman’s work in the year 1958 was recognized as the first step in the inclusion of family therapy in the field. It went beyond the realm of focusing on the intrapersonal processes of the individual. This development is quite significant considering the fact that the individual does not exist alone and is typically attached to his family. If the person has any issue that he is facing, it is more likely than not that the problem can be traced back to the family situation. It usually involves the relationships between siblings, parent and child, and spouses. It is quite logical then that the approach to therapy is centered in the family and not just the individual himself. While something is being done to empower the person, making sure that the family environment is conducive enough for the potential change will provide a solid foundation by which he will be able to stay in a favorable state. This position is confirmed through the contribution of Ludwig von Bertalanffy’s General Systems Theory. This theory postulates that the operation of the system as a whole is affected by the interaction of the parts involved. This theory gave a novel perspective in looking at the state of the family and how it is affected by the members and their assumption of their respective roles. When each family member is able to perform their task well, then harmony within the system is achieved. Needless to say, a family that lacks this kind of functionality is most likely to encounter problems along the way. Meanwhile, during the 1950’s, results of research studies linked family processes with the development of schizophrenia. This connection has been forwarded in various research works in the recent years. For instance, a study conducted by Hooley and Gotlib supported this finding and showed that schizophrenia patients released from the hospital to families with high levels of negatively expressed emotions have high relapse rates. These are highest if the patient has a great deal of contact with the family such as more that 35 hours per week. Once again, it is apparent that the family and its structure can greatly influence the way an individual functions even if the concern is quite personal. Even if the family may not be the source of the person’s illness, it can prove to aggravate it or make recovery a difficult task to accomplish. Furthermore, this finding helped shift the focus on utilizing therapies that included the family to the treatment of disorders which were once considered a result of intrapsychic conflicts. The emergence of marriage counseling and group therapy paved the way for the proliferation of family therapy in the 1970’s.   II. Theories and Therapies Developed Over the Years        As a result of this development, several theories and therapies came about. Among many others, it includes psychodynamic, experiential, behavioral, structural, strategic or brief, solution focused and narrative approaches. The underlying premise of the psychodynamic family therapy is that the unconscious processes of the individual members of the family such as the utilization of defense mechanisms, link family members together and influence their decisions. Therefore, treatment would be focused on examination of the unconscious processes that cause dysfunction in the family. This therapy involves exploring the past in the present scenario so that the same old issues can cease to affect the person in the current state. The unconscious is not readily available though. Psychodynamic family therapy involves strategies that will uncover earlier psychic materials that have been long buried deep down in the unconscious. These issues can sometimes be already forgotten by the individual in the conscious state. But doing something to bring the past to the present will allow him to resolve the psychological issue once and for all. This approach is believed to be quite effective as it targets the root of the problem. The goal is to allow each family member to get rid of unhealthy defense mechanisms that cover up the real problem, resolve them in the present reality, and then give them the opportunity to function in more appropriate ways with the family. On the other hand, Satir and Whitaker are some theorists that proposed the experiential approach. It is grounded on the premise that suppression of feelings is the cause of family problems. There are times when the parents become too strict with their children that they would rather keep their feelings inside than share them with anybody. What is worst is that, some children get severely punished when they try to explain themselves that they may end up getting traumatized by the incident. Consequently, they have their feelings and thoughts all bottled up inside which can blow up later and wreak havoc for the family. However, the parents’ attitude may also have developed as a result of the same treatment in the family that they have belonged to. As such, the situation calls for a family therapy. The goal of this approach, then, is to cultivate an environment of openness and increase emotional closeness of the family members. In the meantime, behavioral family therapy emphasizes the importance of learning. Maladaptive behaviors present in the family members can be altered by punishment and positive behaviors can be accelerated by positive reinforcement. This further implies that if family members intend to deter negative behavior from developing, consequence for such actions should be employed so that the same behavior will not be repeated. In the same way, the favorable attitudes that the family intends to cultivate can be rewarded every time it is done so that the behavior can be displayed again. Evidently, this calls for a consistency and immediacy of the punishment or rewards so that they will truly be able to get imbibed by the family member. This structural approach gives much emphasis on the three concepts including the subsystems, hierarchy, and boundaries. The subsystems refer to the individuals, dyads, and subsets that make up the family. On the other hand, hierarchy pertains to guidance and leadership in the family. Family functioning depends on these elements and the goal of treatment is to bring out the dysfunctional behaviors with the sole intent of altering them. This therapy is effective in managing families with family members who have eating disorders, suicidal tendencies and addiction. Also, Minuchin’s structural approach to family therapy is well suited for counseling the Asian American family, because it focuses on the family unit rather than on the individual (Kim, 1985). The Asian American Family has been known all over the world to be so closely knit that the integral structure can be preserved over the years and include many generations in the family such as grandparents. The emphasis however is in the interaction of the family members and the resulting psychological environment. Srategic theory, also called brief and solution focused, is as its name connotes, have the resolution of present problems through pragmatic and simple ways as its goal. This therapy usually just takes ten sessions or fewer. Unlike the psychodynamic therapies, it deals only with the present reality of the family and does not focus on what has happened in the past. This therapy is quite good to use when the family is undergoing grief over the death of a family member that they might have difficulty trying to overcome. Since the approach is the present, the family issues can be dealt with immediately and do not have to be buried somewhere and be negatively expressed later on in the family life cycle. Finally, the narrative approach is the newest approach embraced by many. It proposes to address the family’s problem by reauthorizing their stories giving them the power to create and materialize their own creative solutions. When each family member is allowed to express their feelings and thoughts without getting censored in any way, it gives them the opportunity to relieve themselves of the burden and make them feel better about themselves. The non-confrontational way by which this is done provides an open environment where the family is not placed under a spotlight in which they will become hesitant to share their deepest thought and emotions. What is most advantageous in the narrative approach is that the person’s creative abilities are used and harnessed while he is trying to resolve the family issue along the process. III. Multiculturalism Counseling        The influx of people of different nationalities to work and live in a country such as the United States of America has necessitated multiculturalism to be incorporated in marriage and family therapy. Different kinds of people with different kinds of languages bring with them their cultural traditions and beliefs. While the same principles can hold true in their country of origin, it may not be as favorably accepted in another country or community. This scenario can inevitably cause conflicts that can turn into deeper concerns for the family. During recent years, there has been an increasing awareness about the importance of cultural background in treating families. The impetus can be attributed to the publication of Ethnicity and Family Therapy in the year 1982. This recent trend is aimed at disclosing how people’s culture affects how they behave and carry themselves within their families and society as a whole.  IV. Counseling the Asian Family        Twenty nationality groups, including Japanese, Koreans, Chinese, Filipinos, Vietnamese and South Asians such as Laotians are encompassed under the umbrella term Asian. This term also includes Pakistanis and Indians. The varied nationalities alone connote a very high degree of diversity—in traditions, beliefs, religion and the like. The term Asian covers a wide variety of identities, languages and cultures, yet this diversity is often ignored when a number of Asian stereotypes are applied. The most common of these are that because Asians tend to look like other Asians, no matter their ethnic groups, they must be alike, and that anyone with an Asian face must be closely tied to his or her ancestral culture (Kitano,1981).  To be able to appreciate, understand and ultimately help an Asian family, then, it is imperative that one should know the family’s “ethnic experience”—the lens from which it sees the rest of the world.   Traditional Asian Values        Despite the existence of difference among the Asian cultures, seven common basic values are embedded in them. A core value is filial piety which is the value of high respect for and obedience to parents. Asian children are expected to prioritize their family’s wishes, even if it means relegating their own aspirations and ambitions. An important attribute to family piety is the ability to carry out the wishes of one’s father and to carry forward his unfinished undertakings of carrying on the past of the family (Sung, 1995). While this may prove to be favorable for the parent, this is not always the case when it comes to children. This is especially true when the parent’s wishes are not the same with that of an offspring. A case in point is the choice of the person to marry. In Asian families, the individual’s decisions in life have to be consulted with other family members even in the most personal aspects. While this can prove to be a guiding factor, it may strip the individual of his self-reliance and develop dependency that he can bring to this adult life. This dependency on parents and other family members can negatively affect the marriage and the new family formed as it can prove to complicate family decisions that are supposed to be made on their own. One good example would be the upbringing and discipline of the child. If grandparents are present in the family and they tend to get too involved in the family affairs, then the child may receive an inconsistent amount of discipline in which parents can be reasonably strict while the grandparents can be overly protective in a negative sense. Understanding this basic Asian family structure can give the therapist the idea about the root cause of the problem that may not be apparent to the family itself. Another basic value is shame, and it is utilized as a method of reinforcing proper behavior and expectations. Actions that are deemed against society’s view of propriety bring shame and loss of face. While the family is a unit that is basic to society, the society is not the ultimate consideration in behavior. For instance, if a family member misbehaves according to the norms of society, using shame to deal with the problem makes the individual feel that people outside the family is more important than himself. This in turn may even lead to the withdrawal of support of family and community members. This withdrawal of support shatters the family structure and breaks down any relationship that has been previously established. The goal of therapy then is to make family members realize that the use of shame to deter negative behavior can only prove to discredit the individuality of the person and make him feel alien to the family. The approach should be then directed towards understanding what the family member is going through and the family giving their sincere support for his recovery. Assuming the middle position is also another common value, which is more inclined to choosing consensus. This value runs contrary to the American mode of individualism and assertiveness. Being in the middle fosters an individual’s sense of belongingness and togetherness, which are also highly valued in Asian culture. Rather than giving out his opinion, an Asian will instead quell it so that he may not be viewed as different, but instead by considered as part of the group. Once again, even if this can prove to be effective in some instances, this will not always hold true. The uniqueness and creativity of the individual can be adversely hampered and could gradually prevent him from developing to the fullest of his potentials. This can be easily seen in the frustrations that some Asians have over a career that was not pursued because the family business has to be prioritized whether it is in the person’s liking or not. Very much related to the one previously mentioned is the value of self-control. Practicing self-control means that the individual displays stoicism and patience even in the face of adversities and restraining his expression of his ardent desire to achieve something up until others relax the boundaries set. This value frowns upon a person’s intrusion of another’s time or resources as a way to accomplish a goal. Again, this is very much unlike the culture of the Americans wherein they assert and voice out up until others react and set limits. Awareness of the social milieu, together with self-control and assuming the middle position, uphold the high premium placed on group orientation of Asian cultures. An individual is expected to put the interest of social solidarity first. If he has a different view of an event, but the majority sees otherwise, then he should subordinate his feelings and instead conform to avoid disharmony. Inconspicuousness has the fear of attracting attention as its roots. Asians in the United States of America would want to feel invisible, which leads them to avoid using government services. This value is also the reason why they avoid counseling services. Fatalism is the Asian’s belief that events that transpire in their life as predetermined. This notion renders them powerless and transforms them into mere spectators of their own lives. If the Japanese has “shi-ka-taga-nai” or “It could not be helped”, then the Filipinos have “Bahala na!” or “Let it be.”  Asian Values in the Face of the Western Dominant Values        Figures have show that Asian Americans or otherwise know as Pacific Islanders, make up the fastest-growing ethnic community in the United States. The U.S. Bureau of the Census (1997) has estimated that by 2020 the Asian American or Pacific Islander population will reach 19.7 million. These Asian Americans have their own inherited cultures, like their ethnicity, nationality, and religion. They also have the so-called acquired culture, which involves learned habits. The western dominant values may at so many times, oppose the traditional Asian values. Western upbringing teaches assertiveness, independence, competition and autonomy while Asian cultures desire self-control, filial piety, conformity and togetherness. Parents are seemingly competing against peer friendships as a medium of influence. While the parents would want to maintain and etch the cultural values and customs of their homeland to their children, school environment teaches them about Western lifestyle—a way of thinking and behaving. Parents may fear losing control their children, since they can see them embracing the Western culture which is very much different from what they are accustomed to. This change may be viewed as insubordination and lack of respect in the part of the children. Asian parents may overreact to American influence and become afraid that their family ties may sever or weaken as a result of the children’s “Americanization” (Liu, 2002). This provides enough reason for escalated conflicts, stressors which necessitates the utilization of culturally family therapy. In this way, the gap between children and their parents can be bridged in two ways. One is that, the parents can be made to understand that their children have now been influenced by another culture and are behaving according to what they have learned from the outside environment. Thus, it is not their children’s intention to disobey them just for the sake of wanting to dissatisfy or make them angry. On the other hand, the children can also be facilitated in therapy to allow them to see where their parents are also coming from. Sometimes, children have this rebellious idea that their parents are just too selfish to allow them to pursue their happiness when their parents just want them to grow up in a civilized manner.  V. Structural Family Therapy for Asian Family I live the tension between a Chinese ideal of filial piety and the American way of self-assertion and independent thinking…I am both, and I value both…I extinguish the conflict for today, because I am Chinese American and I do flow effortlessly between the 2 worlds, because in my world there is only one. (Ying & Lee, 1999, p. 201, as cited in Chae, 2002).         The structural family therapy, developed by Salvador Minuchin, is viewed as a viable model in working with Asian American families who present unique challenges because the members consisting of the immigrant generation or the parents and the generation born in the US or the children have different perspective of the intersection of traditional Asian and Western values. This therapy is deemed fit and proper because it gives due emphasis on the family as a unit more than on individual members. The structural approach sees the family as a set of systems and subsystems boundaries, with leadership and hierarchy. The primary goal of Minunchin’s structural model is to assist the family to change its structure or its organization—specifically establishing a structure in which members and subsystems are clearly differentiated from one another and hierarchically integrated (Navarre, 1998).  VI. Techniques and Interventions        Some of the interventions the structural family approach relies on to bring about change are: joining restructuring, enactment and reframing. Theses techniques are utilized with the intent that it will change the structure of the family system, thereby resolving the presenting problem and symptomatic behavior of the family members. In using this approach with the case aforementioned, the different perspective towards acculturation is the main problem.         Through joining, the counselor establishes a leadership position, which is instrumental in bringing about change in the family system. Since Asian cultures place a high premium on respecting authority figures, then the counselor can use these expectations regarding clear role definitions to promote a more therapeutic situation. At the same time, the family members should be accorded the degree of respect and consideration that ordinarily would accompany their social status. Such a provision of clear, social cues may help the family feel at ease and alleviate anxiety pertaining to initial concerns over status and hierarchy (Kim, 2003). This though, does not mean that the counselor imposes his own values as he assumes the expert role, but instead he should be flexible, perceptive and sensitive to cultural values of the family. The counselor is never subjective that he would incorporate his own feelings and thoughts to the counseling session and give advice to the family on what is appropriate and inappropriate. What he does in order to facilitate change is to let each family member open up and express his own individuality so that the real problem can be defined. Objectivity in structural family therapy is thus very important. In this way, respect can be afforded to all family members. Joining is experiencing reality as the family members would experience it.  (Napoliello & Sweet, 1992, as cited in Kim, 2003). Both parties concerned, the parents and the children, would be asked to elaborate on how they really perceive acculturation. The father would be spoken to first as a sign of upholding the Asian culture of respect and authority, followed by the children. The children will learn that their parents see acculturation as a competition in their efforts to establish Asian values in them. In this sense, it is important that the family members learn to listen and empathize with each other in their own subjective experience. Most of the time, each family member only see their own perspective and they tend to disregard the others in the assumption that they are always right. Structural family therapy calls for the family to truly unite in each other’s experience of reality by putting themselves in the shoes of the family member until they are able to relate to their perspective. During the use of enactment, the family members are encouraged to interact with each other to redirect the communication to themselves and not towards the counselor. This approach will give meaningful information about the underlying structure of the family and the areas wherein which modification is needed. Enactments are intense and emotional occurrences that allow the family counselor to begin restructuring the family. In the case mentioned, the children would be asked to explain to their parents the tension they feel about balancing the 2 cultures they are bombarded with.         Restructuring occurs when the counselor gives suggestion on how the family could change its perception on acculturation, having heard each member’s side about it. Alternatives are offered and the family decides together on how they would solve the problem. In the example, the family could be encouraged to cultivate an environment where rigid rules would be relaxed and loosened. This suggestion though, may focus on the parents as the source of problem. The counselor believes, however, that the problem is interactional and results from a structural problem within the family systems (Yaccarino, 1993).  Through the use of reframing, perceptions are altered, allowing for new frames to develop thus permitting more functional alternatives to emerge (Szapocznik et al., 1986, as cited in Kim, 2003). Through reframing, the counselor guides and assists the family to embrace more flexible margins rather on wallowing on rigid rules that has clearly caused a tension to occur among them. In the example, behavior of the children is reframed as a healthy striving for peer acceptance and not as a sign of disrespect to the authority of the parents. This, subsequently, not only allows greater understanding between the parents and children but ultimately brings about an alternative interaction patterns.  VII. Conclusion        The structural family therapy provides therapeutic elements that are compatible with the culture of Asian Americans. Rather on focusing on the individual, it gives emphasis on the family and the interaction between the members. This, in turn, empowers the family as a whole, more than emphasizing on individual members, and giving them the confidence that they can solve their conflicts together. References Chae, M. H. (2002). Acculturation conflicts among Asian Americans: Implications for practice. The New Jersey Journal of Professional Counseling, 56, 24-30. Chng, C. (1987). Structural Family Therapy in the Treatment of the Chinese American Alcoholic: Family Perspective, 21(1), 49-56. Das, A. K., & Kemp, S.F. (1997). Between two worlds: Counseling South Asian Americans. Journal of Multicultural Counseling & Development, 25, 23-33. Hooley, J.M & Gotlib, I. H. (2000). A diathesis-stress conceptualization of expressed emotional and clinical outcomes. Applied and Preventive Psychology, 9, 135-152. Kim, J. (2003, October). Structural family therapy and its implications for the Asian American family. The Family Journal, 11(4), 388-392. Kim, S. (1985) Family therapy for Asian Americans: A strategic/structural framework. Journal of Family Therapy, 22, 2-5. Kitano, H.H.L. (1981). Asian Americans: The Chinese, Japanese, Koreans, Filipinos & Southeast Asians. Annals of the American Academy of Political & Social Sciences, 454, 125-242. Lee, W. (2004, July). Three “Depressed Families” in transitional Beijing. Journal of Family Psychotherapy, 15(4), 57-71. Liu, W. (2002). Exploring the lives of Asian American men: Racial identity, male norms, gender role conflicts and prejudicial attitudes. Psychology of Men and Masculinity, 3, 107-118. Ma, J. (2000, August). Treatment expectations and treatment experience of Chinese families towards family therapy: Appraisal of Common Belief. Journal of Family Therapy, 22(3), 296-307. Navarre, S. (1998, November). Salvador Minuchin’s structural family therapy and its application to multicultural family systems. Issues in Mental Health Nursing, 19(6), 567- 570. Sung, K.T. (1995). Measures and dimensions of filial piety in Korea. The Gerontologist, 35, 240- 247. U.S. Bureau of the Census (1997). Selected Characteristics of the Population by Citizenship: 1996. Yang, L, & Pearson, V. (2002, August). Understanding families in their own context: Schizophrenia and structural family therapy in Beijing. Journal of Family Therapy, 24(3), 233-257. Ying, Y. W. & Lee P. (1999). The development of ethnic identity in Asian American adolescents: Status and outcome. American Journal of Orthophychiatry, 69, 194-208. Read More