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How 3 Therapists Are Breaking Down Barriers to Mental Health Care in AAPI Communities

In honor of AAPI Heritage Month, three therapists share their unique work, challenges they faced working in this field, and their hopes for the future In honor of AAPI Heritage Month and Mental Health Awareness Month, Verywell spoke to three AAPI therapists about their work. They stressed the importance of AAPI representation in their field and that normalizing mental health care is

  • Posted on 11th May, 2022 22:30 PM
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In honor of AAPI Heritage Month and Mental Health Awareness Month, Verywell spoke to three AAPI therapists about their work. They stressed the importance of AAPI representation in their field and that normalizing mental health care is crucial for Asian and Asian American communities.

Immigrating to the United States at a young age and navigating what it means to be a queer Korean American wasn’t easy for S.H. Moon, PsyD.

Growing up, Moon noticed that her family dynamics were different from others who did not identify as Asian. Mental health was rarely discussed in her family and in the Asian American community.

“That personal experience led me to be really curious about why mental heath isn’t talked about, or why in our culture, reflection or processing our thoughts and feelings were not encouraged,” Moon said.

Those questions motivated Moon to study psychology in college with the goals of better understanding herself and helping other Asian Americans process questions of identity, belonging, and family dynamics too. She is now a licensed clinical psychologist and consultant with specialties working with BIPOC and LGBTQ+ communities.

Asian Americans and Pacific Islanders (AAPI) are one of the most diverse racial groups in the U.S., representing about 50 different ethnic groups and more than 100 languages and dialects. Despite the diverse cultures among AAPIs, it’s common to encounter stigma associated with mental health across communities.

According to a 2019 national survey, AAPIs have the lowest help-seeking rate of any racial group, with less than a quarter of AAPI adults with a mental illness receiving treatment. Some AAPIs may not seek mental health care because of social stigma, language barriers, and insufficient insurance coverage.

These barriers are all too familiar for people like Moon and Angela Wu, LMFT, a Taiwanese American licensed therapist based in Los Angeles.

“My family and I were undocumented for quite some time and going through a lot of financial stress as new immigrants, not having health care, cultural gaps and language barriers, as a kid growing up, that does a number to you,” Wu told Verywell. “On top of that, going through a sexual assault in high school added another layer.”

But Wu was able to go through therapy, and it helped her externalize a lot of self-esteem issues and trauma that she wasn’t previously able to understand. When her parents saw how much healing therapy has brought to her life, they were supportive of her journey to become a therapist.

What It’s Like Working as an AAPI Therapist

Being a therapist and working with people from different cultural backgrounds who’ve experienced varying types of trauma can be challenging.

Wu said since she works with several Asian and Asian American clients, there’s a lot of navigating and unpacking to do regarding racial trauma, identity, acceptance, and collective stigma. Additionally, Wu’s role as a therapist became more demanding during the pandemic due to people losing loved ones because of COVID and the rise in anti-Asian violence.

“As therapists, we carry it all. With the rise of anti-Asian hate crimes during the pandemic, I had to navigate my own grief and racial trauma in order for me to be able to hold space for my clients,” Wu said.

Some people might feel it’s important and perhaps more helpful to work with a therapist of a similar cultural background, according to Jeanie Chang, LMFT, CCTP, a Korean American licensed therapist based in Raleigh, North Carolina. Doing so may allow a client to feel more comfortable without fear of judgment, Chang said.

However, it can be challenging to find an AAPI therapist because according to the American Psychological Association, in 2015, 86% of psychologists in the U.S. workforce were white and only 5% were Asian.

“There’s still not enough of us,” Chang said. “Sometimes I wish I had somebody who could do this with me because in my practice it’s mainly me doing this as the clinical part.”

Being an AAPI in this field is not only challenging and lonely, but it can also be intimidating and uncomfortable.

Chang said beyond working as a therapist, she also teaches workshops that promote mental health, diversity, equity, and inclusion to top leaders including CEOs. But there have been times when she’s faced stereotypes and received comments that were racial microaggressions.

“It can be very challenging as a female Asian American. As an expert telling them about mental health, there have been times where I faced that stereotype of ‘you’re just a really outspoken woman,’” Chang said. “I’ve had to do my job of really building up my own confidence, being rooted in my own values, secure in what I’m doing, and reassuring myself that I belong here.”

Angela Wu, LMFT

Everything that we learned is tailored to how you work with white families and that’s not going to translate across people of color. We have to decolonize our approach and move away from this Eurocentric model.

— Angela Wu, LMFT

The Importance of Representation and Culturally Competent Care

When there is more representation of AAPIs, culturally competent care becomes more accessible, Chang said. 

“You don’t necessarily have to be an Asian to understand an Asian, however, that’s not usually the norm,” she said. “Most Asians want to be able to go to somebody who understands a little bit of their culture instead of having to start from scratch.”

When Moon left graduate school, she didn’t see many therapists or psychologists who looked like her. If there aren’t enough Asian mental health professionals, she said it might force Asian clients to seek therapy with providers who may not truly understand their lived experiences in this country. This could lead to traumatic experiences where the client might encounter harm or racism within a space that is meant for healing.

“There are a lot of things you don’t have to explain or justify when you’re meeting with an Asian therapist,” Moon said. She added that having more AAPI therapists will also help destigmatize conversations around mental health in Asian cultures.

“Mental health is so stigmatized in our culture, the more AAPI we have in this field, the more it will normalize for people that there are so many people who care about this work,” Moon said. “The more people we have in this field, the more it just communicates that this is an important part of one’s life in flourishing and healing.”

In addition, there needs to be more education that’s tailored toward diverse families and experiences, according to Wu. She said psychology students only learn about Eurocentric theories and practices in school.

“Everything that we learned is tailored to how you work with white families and that’s not going to translate across people of color. We have to decolonize our approach and move away from this Eurocentric model,” Wu said. “If you’re not able to deconstruct your own cultural identity within yourself, you’re not going to be able to lead your clients in doing that for themselves.”

Chang added that if graduate students are not trained in understanding diverse experiences, it places the burden on other people of color therapists to educate their peers. She said it’s draining when her colleagues repeatedly asked her to provide context on what their Chinese clients meant.

“If they can just learn about that in graduate school we wouldn’t have to teach that,” Chang said.

Unique Therapy Approaches

Every therapist or psychologist has their own unique way of approaching their practice and working with clients.

For Chang, she uses Korean dramas as a tool to address Asian identity, model minority myths, internalized racism and other cultural values. For example, Chang would assign some of her AAPI clients to watch a specific Korean drama episode or movie and have them reflect on questions related to their experiences. While it isn’t her only therapy approach, she finds it useful in connecting with her clients, especially when working with families.

“For a mom and teen son I worked with, I had them watch a particular scene of a K-drama. The mom watched it and when they came back, it clicked for her,” Chang said. “I use K-dramas because I love them and they’re great for my self care but because they are effective at making a connection to help them [clients] understand their own mental health and distress.”

Wu said she uses a human and social justice-oriented approach—such as educating or helping her clients understand AAPI history or certain lived experiences—when working with her clients.

“I sort of lift that ‘professional’ curtain off because I believe that professionality is just a construct and its intention is to create a power dynamic between you and who you’re servicing,” Wu said.

For Moon, she uses intergenerational and social justice perspectives when working with different clients, especially for those who identify as an immigrant or LGBTQ+. She also uses her identity as a queer person herself to help guide and support AAPI folks who don’t have affirming friends or family members to navigate their gender or sexual identities.

“Oftentimes in western psychological perspective, healing is done in a therapy room by processing, reflecting or getting coping skills,” Moon said.

But it's also important to offer clients ideas and resources on connecting with their community, she said, whether that means getting involved in advocacy work or finding a safe space for themselves.

What This Means For You

It’s important to understand that you are not alone in the experiences you have faced and may continue to experience. Speak with trusted friends, family, or community organizations when looking for help or culturally competent therapy and care.

Hopes for the Future

Wu, Chang, and Moon shared similar hopes and expectations in the field of mental health, including:

  • More AAPI representation
  • Providing education and training to students and experts regarding diverse lived experiences 
  • Normalizing mental health issues in the AAPI community
  • Normalizing seeking help and mental behavioral care
  • Encouraging and supporting others in the AAPI community

“My hope is for healing and recognition of what AAPI folks have experienced in this country whether it’s anti-Asian violence, racism, or microaggressions,” Moon said. “We are strong, we are powerful, and we have a history of fighters in our ancestors, and to be able to heal so that we can continue to access that kind of strength, is my hope.”

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