School Psychological Service Delivery to the South-East ...book, School Psychology for the 21st...

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Author: Romstad, Carl, T

Title: School Psychological Service Delivery to the South-East Asian Population: Are

Current and Future Service Providers Adequately Prepared? The accompanying research report is submitted to the University of Wisconsin-Stout, Graduate School in partial completion of the requirements for the Graduate Degree/ Major: Ed.S. School Psychology

Research Advisor: Kevin Doll, Ph.D.

Submission Term/Year: Spring, 2013

Number of Pages: 87

Style Manual Used: American Psychological Association, 6th edition

X I understand that this research report must be officially approved by the Graduate School and that an electronic copy of the approved version will be made available through the University Library website

X I attest that the research report is my original work (that any copyrightable materials have been used with the permission of the original authors), and as such, it is automatically protected by the laws, rules, and regulations of the U.S. Copyright Office.

X My research advisor has approved the content and quality of this paper.

STUDENT:

NAME Carl T. Romstad DATE: 3/15/2013

ADVISOR: (Committee Chair if MS Plan A or EdS Thesis or Field Project/Problem):

NAME Kevin Doll DATE: 4/10/2013

--------------------------------------------------------------------------------------------------------------------------------- This section for MS Plan A Thesis or EdS Thesis/Field Project papers only

Committee members (other than your advisor who is listed in the section above)

1. CMTE MEMBER’S NAME: Kevin Doll DATE: 4/10/2013

2. CMTE MEMBER’S NAME: Jacalyn Weissenburger DATE: 4/10/2013

3. CMTE MEMBER’S NAME: Michael Lawler DATE: 4/10/2013

----------------------------------------------------------------------------------------------------------------------------- ---- This section to be completed by the Graduate School

This final research report has been approved by the Graduate School.

Director, Office of Graduate Studies: DATE:

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Romstad, Carl T. School Psychological Service Delivery to the South-East Asian Population:

Are Current and Future Service Providers Adequately Prepared?

Abstract

Every year, colleges and institutions of higher education (IHE) award school psychology

degrees to individuals dedicated to help individuals with educational needs. Of the required

courses needed to earn the degree and practice the school psychology profession, virtually none

deal with methods of service delivery for populations other than those of the Euro-American

Judeo-Christian population. Given the steady change in the demographics of the public

educational system and the influx of culturally/linguistically diverse students, cross-cultural

service delivery courses need to be included in the core class requirements for school

psychologists in training. Individuals from the South-East Asian ethnicity/culture, which is made

up of many smaller individual ethnicities/cultures, may possess views about psychological

service delivery that are significantly different from other ethnic groups. School psychologists

need to be aware of the views and needs of this population. Current school psychology training

programs may not adequately prepare future service providers to understand and respond to this

population. This study examined the significant need for more extensive cross-cultural

education, specific to the South-East Asian population, to ensure effective school psychology

service delivery for this population in the public education system.

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Acknowledgments

I would like to thank my wife, Pajyeeb Yang-Romstad, for supporting me throughout my

graduate school experience and providing the insight that became the primary factor in my thesis

topic selection. I would also like to thank my family, Gary, Barbara, Erik and Lauren Romstad,

for their unwavering faith in my integrity and abilities when I faced challenges at UW Stout; they

were my advocates when I most needed encouragement. I am grateful for the Yang family’s

support while I pursued my Ed.S degree; the value they place on education continues to be an

inspiration. Also, I would like to thank Chong Yang as he was a huge part of my initial research

and data gathering. Finally, I would like to thank the members of my thesis committee, Dr.

Kevin Doll, Dr. Jacalyn Weissenburger, and Dr. Michael Lawler. Each member contributed a

unique perspective to my research. They remained open-minded and genuinely interested in the

thesis from the topic selection stage through to its completion. A very special thank you to Dr.

Kevin Doll for supporting this topic from its earliest phase, helping me research it, and being

patient throughout the process. Thank you.

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Table of Contents

...………………………………………………………………………………………Page

Abstract…………………………………………………………………………………

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List of Tables...................................................................................................................

6

Chapter I: Introduction………………………………………………………………...

7

Statement of the Problem……………………………………………………..

12

Purpose of the Study…………………………………………………………

12

Research Questions…………………………………………………………….

12

Definition of Terms……………………………………………………………

13

Chapter II: Literature Review…………………………………………………………..

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The Roots of Modern Psychology……………………………………………...

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The History of School Psychology…………………………………………….

20

Code of Ethics and Guidelines for Standards…………………………………

23

The Product of a Culturally Biased Social Science……………………………

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The Role of Academia and Cross-Cultural Competency………………………

26

Cross-Cultural Curricula………………………………………………………

28

Serving the South-East Asian Population……………………………………...

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Chapter III: Methodology………………………………………………………………

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Part One Methodology: Qualitative Research………………………………….

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Grounded Theory……………………………………………………………….

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Participant Selection……………………………………………………………

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Survey Instrument………………………………………………………………

36

Data Collection Procedures…………………………………………………….

37

Data Analysis…………………………………………………………………... 37

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Part Two Methodology: Quantitative Research……………………………….

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Participant Selection…………………………………………………………...

38

Survey Instrument………………………………………………………………

39

Data Collection Procedures…………………………………………………….

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Data Analysis…………………………………………………………………...

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Chapter IV: Results…………………………………………………………………….

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Results of Part One: Grounded Theory……………………………………….

41

Results of Part Two: Quantitative Survey…………………………………….

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Chapter V: Discussion………………………………………………………………….

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Part One Important Research Findings………………………………………...

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Part Two Important Research Findings……………………………………......

55

Overall Findings………………………………………………………………..

61

Limitations of The Study……………………………………………………….

64

Implications for Future Research……………………………………………....

65

Implications for Practice………………………………………………………..

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Summary………………………………………………………………………..

67

References……………………………………………………………………………...

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Appendix A: Survey Instrument 1 – Grounded Theory Interview……………………..

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Appendix B: Survey Instrument 2 – Quantitative Data Gathering Survey…………….

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Appendix C: Consent to Participate – Grounded Theory Interview…………………...

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Appendix D: Consent To Participate - Quantitative Survey…………………………..

85

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List of Tables

Table 1: Results, Participant Questionnaire: Question 1……..……………………………Page 48







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Chapter I: Introduction

Modern psychology dates back thousands of years to early the philosophers in Greece

and has been practiced in some form until present day (Griffin, 2005). The practice of

psychology is based on the concept that a trained professional is able to meet with a client who

may be experiencing a problem emotionally, behaviorally, and/or mentally, and help the

individual solve his/her problem through some form of psychological service. This practice is

currently accepted in the United States as well as in many other western countries. Psychology

has many sub-disciplines, in particular, school psychology, which has been implemented in the

public and private educational system (Merrell, Ervin, & Gimpel, 2006). The primary discipline

of psychology was developed by a small portion of society, Euro-American Judeo-Christian

males, and the field is currently being questioned in regards to its application to certain

ethnicities or cultures (Arnett, 2008). According to Frisby and Reynolds (2005), the specific

subsystem of school psychology is one that is currently seen as a “mono-cultural” model, being

shaped and modified by the dominant culture in the United States, one with Euro-American

Judeo-Christian cultures ideals, values, morals, and life initiatives.

Frisby and Reynolds (2005) suggest that as our society rapidly becomes more culturally

and linguistically diverse (CLD), it is important for future school psychologists to be aware of

the roots of modern psychology and how these roots may or may not relate to meeting the needs

of the United States population. In a recent article entitled, The Neglected 95%, author Jeffery J.

Arnett (2008) writes that the world population is 6.5 billion while the United States has reached

300 million. If one looks at these numbers and the trends of American psychological research, it

appears that researchers focus on only 5% of the world population. The changing demographic

characteristics of the world will continue to have an impact on the United States as the influx of

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immigrants continues to rise every year (Arnett, 2008). It has been projected that by the year

2050, racial and ethnic minorities will account for 47% of the of the nation’s population (U.S.

Census Bureau, 2009). Furthermore, based on this projection, the distribution of the population

will be 50.1% Euro-Americans, 24.4% Hispanic/Latino-American, 14.6% African American, 8%

Asian-American, and 5.3% all others (U.S. Census Bureau, 2009). In alignment with these

changing demographics, the student population of the public education system is now made up

of multiple ethnicities and cultures. Recent studies, such as those conducted by the National

Center of Educational Statistics (NCES), suggest that almost half of the population in the public

education system in 2007 (44.1%) is of a different ethnicity or culture that Euro-American

(NCES, 2007a).

As historically underrepresented populations continue to grow in our nation’s educational

system, pupil service providers may need to adjust to provide culturally appropriate support

(Frisby & Reynolds, 2005). This change may look different depending on regional

demographics. For example, if the reader looks at specific regions of the country, the reader will

see that the Northeastern portion has a minority population of 34%, the Midwest has a population

of 28%, the South has a population of 48.9%, and the West has a population of 56.6% (NCES,

2007b). The data suggests that in some parts of the country not only are minorities significantly

present, but almost equal the Euro-American population. If one considers these numbers and

compares them to the demographics of people in the field of school psychology, a large

disproportion of CLD service providers exists (Frisby & Reynolds, 2005).

Despite the need for the adequate preparation of school psychologists, there appears to

be a shortage of CLD school psychologists to meet the psychological needs of English Language

Learner (ELL) children. The need for increasing the number of CLD school psychologists has

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also been supported by the findings of a recent survey of practicing school psychologists. In the

book, School Psychology for the 21st Century: Foundations and Practices (Merrell et al., 2006),

only 5.5% of practicing school psychologists were from historically underrepresented

populations, and one in ten were fluent in a second language (Merrell et al., 2006).

The underrepresentation of CLD school psychologists is further evident by survey

findings. In one survey of members of the National Association of School Psychologists

(NASP), the ethnic breakdown of NASP members was 91% white/ Euro-American, 1.7%

Hispanic, 2.4% African American, 1.1% Asian/Pacific Islander, and 0.6% American

Indian/Alaskan Native (NASP, 2003). These statistics suggest that minorities are significantly

under-represented in the field of school psychology. Therefore, it is important to educate the

Euro-American majority who are aspiring to be school psychologists in different ethnicities and

cultures to be better prepared to help all students, regardless of their ethnicities and cultures.

This need is not only recommended, but mandated by organizations such as NASP and the

American Psychological Association (APA) (APA, 2002; NASP, 2000a; NASP, 2000b).

Although the need for developing multicultural competencies has been well documented

(APA, 2002; Fowers & Davidov, 2006; NASP, 2000a; NASP, 2000b), school psychologist

training programs may not be emphasizing the importance of such training enough (Banks &

McGee-Banks, 1995; Rosenfield & Gravois, 1998). This is further exacerbated by the fact that

despite more than two decades of pupil service providers advocating for multicultural training at

the university level, only one or two courses are offered in most institutions of higher education

(Banks & McGee-Banks, 1995; Rosenfield & Gravois, 1998). Roger, Hoffman, and Wade

(1998), for example, surveyed certain APA-accredited counseling and school psychology

programs and found most of the programs only offered one multicultural course. While future

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school psychologists are being trained with Euro-American Judeo-Christian based psychological

theory and practice only some are required to take a course to address issues of cross-cultural

service delivery and multicultural issues. As a result of this it is unquestionable that these future

professionals will be underprepared to accommodate the CLD population (Banks & McGee-

Banks, 1995; Roger et al., 1998; Rosenfield & Gravois, 1998).

Aside from the demographic change in our nation’s public school system and the lack of

cross-cultural competency training in academia, a school psychologist is ethically bound to

understand how to best give services to diverse populations. In recent years, professional

organizations such as NASP and APA have developed guidelines and ethical standards to

incorporate multicultural content into the training curricula (APA, 2000; APA, 2002; NASP,

2000a). These guidelines articulate a strong commitment to diversity by establishing certain

priorities; however, no specific recommendations for transforming traditional training curricula

into a multicultural curriculum designed to enhance cultural competence and provide a

supportive training environment seem to be provided.

The need for developing cultural awareness, knowledge, and skills through professional

programs has not been given ample attention. Sue and Sue (2003) described cultural competence

as a kind of personal awareness in which “. . . a culturally competent professional who is active

in the process or aware of his own assumptions, human behavior, perceived notions, personal

limitations, and so forth” (p. 178). It is not only in the best interest of the school psychologist to

have a good understanding of cross cultural service delivery methods and multiculturalism, it

would be unethical to not have this knowledge when delivering services to those of different

ethnicities and cultures (Merrell et al., 2006).

When considering the need for CLD school psychologists, there are two main ideas to

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keep in mind. First, when comparing the data, it is obvious that almost half of the population of

the public school system is of non Euro-American/ethnicity, yet 94.5% of people going into the

field of school psychology are Euro-American (Merrell et al., 2006). Second, it should also be

noted that the ethical standards of both the NASP and APA require a firm understanding of

different ethnicities and cultures to deliver services to all clients in need; however, the education

future school psychologists receive in this area is marginal (Roger et al., 1998). An astute

student of school psychology, on being exposed to ethnic/cultural differences, will acknowledge

that some of the concepts and techniques of modern psychology, which is based on Euro-

American Judeo-Christian beliefs and values, may not be effective for all (Behring & Ingraham,

1998).

By limiting the professional knowledge of the cultures school psychologists are helping,

professionals are limiting the help they can deliver (Behring & Ingraham, 1998). While the

majority of the population in the United States is of Euro-American and Judeo-Christian descent,

a large segment is neither. It is this segment that may not be well served with the principles of

modern psychology currently taught in colleges and universities (Behring & Ingraham, 1998).

The literature and theories studied by school psychologists is based on the ideas of Euro-

American Judeo-Christians, suggesting that it is unlikely they will be able to deliver effective

services to students of different ethnicities and cultures (Behring & Ingraham, 1998). Until the

curriculum includes a variety of classes intended to broaden the multicultural knowledge of the

students, academia will simply produce school psychologists, not multiculturally competent

school psychologists, or those who have a balance of skills including a knowledge of scientific

objectivity, a passion for advocacy, a firm understanding of historical politics and social policy,

as well as an awareness of the expanding research on multicultural issues of psychological theory

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and practice (Frisby & Reynolds, 2005).

Statement of the Problem

According to many, school psychologists are not fully able to effectively provide services

to the entire current student population, specifically those of the South-East Asian

ethnicity/culture in the United States public school system because the theories and techniques

they are taught are rooted in the values and beliefs of Euro-American Judeo Christians. As such,

many programs do not include alternative options or cultural views based on those of the CLD

population, specifically the South-East Asian ethnicity/culture population.

Purpose of the Study

The purpose of this study was to 1) Identify themes in areas of concern pertaining to the

fundamental education received by current professionals in the field of mental health and how

those concerns were related to the service delivery techniques for South-East Asian clientele, and

2) Examine the level of cross-cultural service delivery knowledge pertaining to South-East Asian

clientele in school psychology training programs and current school psychologists in the public

educational system earning their degree in higher academia. This research was conducted in the

year of 2012.

Research Questions

Seven research questions were used to guide the study.

The following questions guided the qualitative part of this study:

1. Are the foundational theories and methods learned pertaining to mental health service

delivery fully applicable or practical for the South-East Asian clientele?

2. Are there any fundamental practices or themes commonly used in the field of mental

health that are less accepted or taboo for the South-East Asian clientele you serve?

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3. Are mental health service providers adequately prepared through their education alone to

serve South-East Asian clientele?

The following questions guided second part of this study:

4. Do school psychology students have knowledge of delivery methods for the South-East

Asian culture?

5. Do school psychology students have formal training in the South-East Asian culture?

6. Do school psychology students feel comfortable and/or have the ability to implement

service delivery methods for the South-East Asian culture?

7. Do school psychology students find it important to use cross-cultural service delivery

methods for clientele of the South-East Asian culture?

Definition of Terms

To understand the content area of this study, certain terms may need clarification. The

terms are as follows:

Anglo-america. “Americans whose biological and cultural heritage originated in

England, or Americans with other biological and cultural heritages who have assimilated into the

dominant or mainstream culture in the United States” (Banks & Banks, 1997, p. 433). For the

purpose of this paper, Euro-Americans will be used in place of the more common term, Anglo-

American.

Cultural competence. “A set of congruent behaviors, attitudes, and policies that come

together in s system, agency, or among professionals and enables that system, agency, or those

professionals to work effectively in cross-cultural situations” (NASP, p. 1, 2003).

Culture. “A pattern of shared basic assumptions that was learned by a group as it solved

its problems of external adaptation and internal integration that has worked well enough to be

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considered valid and, therefore, to be taught to new members as the correct way to perceive,

think, and feel in relation to those problems” (Schein, 1992, p. 17).

English language learners (ELL). Students whose first language is not English and who

are in the process of learning English (Department of Education: Office of English Language

Acquisition, 2006).

Ethnic group. “A micro cultural group or collectivity that shares a common history and

culture, common values, behaviors, and other characteristics that cause members of the group to

have a shared identity” (Banks & Banks, 1997, p. 434).

Ethnic majority. “. . . a dominant ethnic group that collectivity within a society has

preeminent authority or comprises the majority of a population to function both as guardians and

sustainers of the controlling value system and as prime allocators of rewards in the society”

(Kaufmann, 2004, p. 86).

Ethnic minority group. “An ethnic minority group has distinguishing cultural

characteristics, racial characteristics, or both, which enable members of other groups to identify

its members easily” (Banks & Banks, 1997, p. 434).

Euro-american “. . . an American of European and especially white European descent”

(Merriam-Webster’s online dictionary, 2012).

Judeo-christian. “. . . is meant to encompass the perspectives of both Judaism and

Christianity, as historic and living world religions. It recognizes the origins and continuity of

Christianity with Judaism, but the term is not meant to subsume either faith with the other…”

(Miller & Delaney, 2005, p. 5).

Multiculturalism. “A philosophical position and movement that assumes that the gender,

ethnic, racial, and cultural diversity of a pluralistic society should be reflected in all of the

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institutionalized structures of educational institutions, including the staff, the norms and values,

the curriculum, and the student body” (Banks & Banks, 1997, p. 435).

Multicultural school psychologist. “… a service provider who respects and honors the

dignity of human variation…and subsumes the intention of the careful consideration of the

individual as a psychological system interacting with one or more cultural systems. An

individual who is aware of the distinct and expanding literature on multicultural issues in

psychological theory and practice…” (Frisby & Reynolds, 2005, p. 14-28).

Natural science. “Any of the sciences (as physics, chemistry, or biology) that deal with

matter, energy, and their interrelations and transformations or with objectively measurable

phenomena” (Merriam-Webster’s online dictionary, 2012).

Racial micro-aggression. “…brief and commonplace daily verbal, behavioral, or

environmental indignities, whether intentional or unintentional, that communicate hostile,

derogatory, or negative racial slights and insults toward people of color” (Sue, Capodilupo,

Torino, Bucceri, Holder, Nadal, et al., 2007, p. 271).

Religion. “A set of beliefs and values to which an individual or group has a strong

loyalty and attachment. A religion usually has moral codes, rituals, and institutions (society) that

reinforce and propagate its beliefs” (Banks & Banks, 1997, p. 436).

Self-efficacy. “Degree to which an individual feels confident that he or she can perform

a task successfully” (Bruning, Schraw, Norby, & Ronning, 2004, p. 368).

Social science. “A branch of science that deals with the institutions and functioning of

human society and with the interpersonal relationships of individuals as members of society”

(Merriam-Webster’s online dictionary, 2012).

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South-east asian. “. . . political organization consisting of Brunei, Cambodia, Indonesia,

Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, & Vietnam” (Merriam-Webster’s

online dictionary, 2012). The definition illustrates geopolitical boundaries of the area considered

to be South-East Asia. For the purpose of this study, the term “South-East Asian” will apply to

those whose ethnicities and cultures are from this geopolitical area.

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Chapter II: Literature Review

This chapter will include reviews pertaining to the concept that the historical roots of

psychology have embedded a cultural bias in the discipline of modern psychology, including one

of its sub-sets, school psychology. It will also include reviews concerning the level of

competence school psychologists have in providing effective service delivery to

underrepresented populations in the United States public school system. Finally, this chapter

will include a review specific to the effectiveness of current psychology practices to serve the

South-East Asian population. The topics reviewed are the historical roots of modern

psychology, the history of school psychology, the code of ethics and guidelines for standards, the

product of a culturally biased social science, the role of academia and cross-cultural competency,

cross-cultural curricula, the need for cross-cultural school psychology, and specific concepts and

issues pertaining to serving the South-East Asian population.

The Roots of Modern Psychology

The methods and techniques of modern psychology are based exclusively on Euro-

American Judeo-Christian theorists and psychologists. In the article titled The Roots and

Branches of Psychology: Historical and Contemporary Views on Human Nature and

Psychology, Griffin (2005) states that the psychology, as it is currently studied in the United

States and Europe, was first based on Greek culture. He cites early poems such as the Iliad and

the Odyssey as having multiple references to Homer’s philosophy of human nature. According

to Griffin (2005), this early Greek philosophy was adopted and refined in Western Europe to

become the basis of modern psychology.

Brennan (1982) writes that if one truly has a respect for the discipline of psychology, he

or she must then understand its roots. He adds that philosophers of western European origin

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acquired vast knowledge of philosophical perspective from the Greek culture, eventually

adapting it as their own. During the Renaissance, Christian philosophers contributed their

concepts to these philosophies. These refined philosophies that combined Christian concepts

with ancient Greek became generally accepted teachings in Europe and evolved to become

nineteenth century psychology (Brennan, 1982).

The discipline of modern psychology not only has Greek and European roots, it is also

rooted in the practice of Judeo-Christianity (Brennan, 1982; Griffin, 2005). One prominent

figure in the practice of modern psychology is Sigmund Freud, a European male of Judeo-

Christian faith (Sharf, 2004). In the late 1800s, Freud developed multiple theories and methods

of psychotherapy, and, in particular, psychoanalysis. The significant practice of psychoanalysis

in the mid 20th century is evidence that every theorist at the time was directly or indirectly

impacted by Sigmund Freud’s theories (Sharf, 2004).

Other prominent contributors to the field of modern psychology were impacted by Freud,

including Anna Freud, Carl Jung, Alfred Adler, and Erik Erikson (Sharf, 2004). Sub-disciplines

of psychology such as Behaviorism, Humanism/Existentialism, and Cognitivism, although not

directly related to the work of Freud, were influenced by his theories (Sharf, 2004). Although

some theorists such as Adler and Jung questioned Freud and considered his methods to be sloppy

and his conclusions questionable, all prominent contributors to modern psychology were of the

Euro-American Judeo-Christian culture (Sharf, 2004).

In the book, School Psychology for the 21st Century, Merrell and colleagues (2006)

wrote:

Freud’s deterministic view of human behavior and the unconscious was truly

revolutionary. Although many of his theories have now been rejected even by

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proponents of the psychodynamic approach he pioneered, one must not overlook the

enormity of his contributions and influence. Even today, his metaphor of the conscious

being the ‘tip of the iceberg’ of human experience is widely used, and the influence of his

work in Western cultures cannot be minimized (p. 25).

It is clear that Freud’s contributions to the discipline of psychology and counseling were

significant. Religion, a part of Freud’s life, added to the development of his theories. Although

it is questioned as to how closely Freud followed his faith, in the book, Freud and Moses: The

Long Journey Home, author Rice (1990) suggests that he was, in fact, very much influenced by

the Judeo-Christian religion. Biblical stories seem to have been a significant part of Freud’s

thought process as he would often reference biblical themes and figures. One specific biblical

example cited by Freud was Joseph, the man who interpreted dreams (Rice, 1990). The Euro-

American Judeo-Christian roots of psychology have greatly shaped the contemporary practices

of the discipline (Griffin, 2005; Rice, 1990).

Contemporary professionals in the field of psychology have commented on the current

practice of psychology and its cultural bias (Arnett, 2008; Merrell et al., 2006). If one reviews

literature pertaining to psychology in the recent decade, one will find most studies were

conducted by Euro-Americans with clients of the same culture (Arnett, 2008). This suggests that

the concept of Euro-American Judeo-Christian values being engrained in the field of psychology

is highly likely (Behring & Ingraham, 1998). As such, providing psychological services to

individuals who are not of Euro-American Judeo-Christian culture may be more challenging than

providing the same services to those of the Euro-American Judeo-Christian culture. It is

important that modern psychology practices be re-evaluated in a multicultural sense to better

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serve the needs of the diverse population of the United States (Behring & Ingraham, 1998).

The History of School Psychology

The early years (1890-1969). As western society progressed through the late 19th and

early 20th centuries, psychology began to become more mainstream (Merrell et al., 2006), and

multiple sub-disciplines branched off from the larger discipline of psychology. This section will

review the history of one specific sub-discipline, school psychology. The history of school

psychology dates back to the late 1800s and early 1900s (Merrell et al., 2006). Prior to the Civil

War, the country’s public educational system consisted of “common schools.” During the

reconstruction period of the United States after the Civil War, the more powerful centralized

government added the building of schools to its agenda and also devised a plan to finance these

schools, creating what could be considered the blueprint for the public educational system

(Merrell et al., 2006). The development of the public educational system, combined with the

social conditions during and after the reconstruction period, presented new challenges to those

involved in the field of education. It was during this time that the concept of psychology was

introduced to the United States, as well. This set the stage for the advent of school psychology

(Merrell et al., 2006).

According to Bardon and Bennett (1974), Lightner Witmer of the University of

Pennsylvania created a psychological clinic designed to teach psychologists to help educators

identify and solve learning problems in children in 1896. As a result of his efforts, Witmer has

been labeled the founder of school psychology (Bardon & Bennett, 1974). Francis Galton was

involved in similar work in London. Twelve years earlier, Galton developed programs to help

schools academically identify and classify students (Merrell et al., 2006). In both instances,

professionals in the discipline of psychology applied their knowledge to the public educational

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system, thus creating school psychology. At the onset of the 20th century, the discipline of

school psychology was distilled and modified further (Bardon & Bennett, 1974; Merrell et al.,

2006).

In 1905, in Paris, France, psychologists Alfred Binet and Theophile Simon were ordered

by the Minister of Public Education to develop a way to identify school children who were

having a difficult time adapting to the curriculum and find an alternative way for them to learn

(Merrell et al., 2006). Thus, the Binet-Simons scales were created, and became the first tests to

measure modern intelligence. These tests proved so useful that they were adopted in the United

States by Lewis Terman of Stanford University. The scales were translated into English, and the

role of the school psychologist became synonymous with testing and assessment in the public

educational system (Merrell et al., 2006).

The title of school psychologist would later be officially given to Arnold Gesell when,

from 1915 to 1919, he was appointed this title. As time progressed, the term was used more

frequently in the educational system and linked to delivering psychological services to youths

considered at risk. The sub-discipline of school psychology, although highly unregulated and

unofficial, had been created (Merrell et al., 2006).

The modern years (1970-2000). Thomas Fagan summarized the history of school

psychology into two time periods, the hybrid years and the thoroughbred years (Merrell et al.,

2006). The hybrid years, those between 1890 and 1969, were characterized by the emergence

and intense evolution of the discipline. The thoroughbred years, those between 1970 and 2000,

were characterized by stability in the profession and the official recognition of school

psychology (Merrell et al., 2006).

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As the public educational system expanded its scope, it became more refined in its

attention to individual students needs, as did the discipline of school psychology (Merrell et al.,

2006). The founding of NASP in 1969 was of great significance to the field as it gave the

discipline official nationwide credibility (Merrell et al., 2006). Government intervention in the

public school system and continuous legislation for students with special needs changed the field

even further. In 1975, Public Law 94-142, Education for All Handicapped Children Act, was

passed by the federal government making it the first law created specifically for children with

disabilities (Merrell et al., 2006). This law had an enormous impact on the field of school

psychology for three reasons. First, because this was a federal law pertaining to the needs of

students eligible for special education, more school psychologists were needed to determine

eligibility. Second, more specific requirements and greater expectations were placed on school

psychologists-in-training and in the field. Finally, the multiple amendments to Public Law 94-

142 served to continually alter and expand the role of all educators, including school

psychologists. As more demands were placed on school psychologists, broadening their

knowledge and skills was critical in order to meet the increasing needs of the public school

system (Merrell et al., 2006).

From its earliest introduction to present day, the role of school psychology has changed

dramatically. The field has foundations in both the discipline of psychology and the discipline of

education (Merrell et al., 2006). School psychology has progressed from the late 19th century to

modern day. The role of the school psychologist, the definition of the school psychologist’s

client, and the services that school psychologists deliver have evolved over time. Continued

progress in the field is necessary if its goal is to serve all in need. As the population served by

23

the public education system becomes more ethnically and culturally diverse, the discipline of

school psychology must also diversify to be cross-culturally competent (Merrell et al., 2006).

Code of Ethics and Guidelines for Standards

A number of national organizations have developed school psychologists’ Code of Ethics

and Standards for Training (NASP, 2000b; APA, 2002), a publication outlining the expected

level of competencies and responsibilities of professionals working with CLD children, youth,

and their families. In the ethical standards for both NASP and APA, there is a specific guideline

for delivering services to diverse populations (NASP, 2000b; APA, 2002).

The NASP professional conduct manual outlines the expectations of the school

psychologist in terms of service delivery to diverse populations. NASP states, “School

psychologists respect differences in age, gender, sexual orientation, and socioeconomic, cultural,

and ethnic backgrounds…” (NASP, 2000b, p. 27).

The American Psychological Association (APA) has demonstrated a similar interest in

requiring multicultural competencies of all service providers. In the APA ethical standards, it

states that service providers should adhere to boundaries of competence:

“…establishes that an understanding of factors associated with age, gender, gender

identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability,

language, or socioeconomic status is essential for psychologists to ensure the competence

of their services, or they make appropriate referrals…” (APA, 2002, p. 5).

Establishing ethical standards has added another responsibility to the duties of the school

psychologist, the need to be cross-culturally informed. Even though the requirement to be cross-

culturally competent is outlined in the NASP and APA codes of ethics, professionals have

openly expressed concern about working with and giving effective services to individuals in a

24

cross-cultural context. This concern is not limited to the borders of the United States, but is also

shared by those in other countries as they believe that school psychology will be limited in terms

of diversity training and issues (Sandoval, 2007).

The Product of a Culturally Biased Social Science

Understanding the history of school psychology and the empirical research supporting the

practice is paramount when considering the possible shortcomings of the discipline and its cross

cultural application (Behring & Ingraham, 1998). Katz (1985) points out that the United States

and Europe are two societies largely impacted by the values of religion, specifically Judeo-

Christianity. Psychology, as it is practiced today in the United States and Europe, is a social

science created in the West (Griffin, 2005). A social science differs from a natural science in

that a social science is based off the interpersonal relations of the members of particular

societies, spiritual beliefs, and customs rather than mathematical and physical concepts that deal

with objectively measurable phenomena that transcend cultures (Boutellier, Gassman, & Raeder,

2011). The social sciences of Europe and the United States have values and morals founded in

the Judeo-Christian religions (Griffin, 2005; Katz, 1985). A social science developed in a

society influenced by a set of religious values and beliefs will be influenced by those very same

values (Griffin, 2005; Katz, 1985).

If the basis of a social science is limited to a specific society or a segment of a society’s

population, that social science cannot be assumed to be applicable to any society or segment of a

society other than that which was its basis (Katz, 1985). Unless a psychologist, or in the case of

this study a school psychologist, is aware of the cross-cultural limitations of the social science of

modern psychology, he or she may unknowingly impose the values of the Judeo-Christian

society on the clients he or she is helping (Behring & Ingraham, 1998; Katz, 1985).

25

Being cross-culturally competent can be defined as acknowledging and respecting

different individual identities, beliefs, values, methods of communication, morals, and behaviors

(NASP, 2003). Research in the areas of non Judeo-Christian philosophies and their impact on

effective psychological service delivery is currently being conducted in societies outside of the

United States and Western Europe (Arnett, 2008). Practitioners in the United States have been

mostly uninterested in contributions from the international community, and as a result, one might

speculate that modern psychology in the United States is cross-culturally deficient (Arnett,

2008). A study conducted by Arnett illustrated that, regardless of psychological research abroad,

six professional psychological journals readily available for psychologists to utilize, contained no

information on treatment and therapy techniques other than those of Euro-American Judeo-

Christian studies.

Arnett (2008) conducted a study of a series of journal articles pertaining to psychology.

The journals he investigated were: Developmental Psychology, Journal of Personality and Social

Psychology (JPSP), Journal of Abnormal Psychology (JAP), Journal of Family Psychology

(JFP), Health Psychology, and Journal of Educational Psychology (JEP). The number of articles

reviewed from these professional journals totaled 4,037. Among first authors, overall, 73% were

based at American universities; the percentage of first authors who were affiliated with

American universities ranged across journals from 65% (JPSP) to 85% (JFP). An additional

14% of first authors were from English-speaking countries (not including the United States), and

11% were from Europe. First authors not from the United States, other English-speaking

countries, or Europe was 2%. Only 1% of first authors were either from Asia or Israel, and none

from Latin America, Africa, or the Middle East (Arnett, 2008).

26

Arnett (2008) also studied the multiple aspects of culture in terms of developmental

psychology, gender roles, marriage, and educational psychology. According to Arnett (2008),

recognizing multiple aspects of a culture is important when providing services to youth of non

Euro-American Judeo-Christian culture in the United States public school system. Such a

student may face a challenge in one or several aspects of development, gender, marriage and

family, and education and it is the responsibility of school psychology professionals to seek a

better understanding of the many different cultural values regarding these topics (Arnett, 2008).

In academia, if professionals are committed to providing the best services for their clients and

meeting the ethical standards of professional organizations, they must have a better concept of

multiculturalism and cross-cultural competencies (Behring & Ingraham, 1998).

The Role of Academia and Cross-Cultural Competency

According to Behring and Ingraham (1998), as the demographics of the United States

change in terms of race/ethnicity and culture, it is absolutely vital that more cross-cultural

education is required of school psychologists. Frisby and Reynolds (2005) conducted a study on

a national sample to measure cross cultural and multicultural training for school psychologists in

doctoral and non-doctoral programs and concluded that: 40% of the programs involved in the

study had no classes pertaining to minorities or cultural issues; 45% of the programs involved in

the study had 15% of time devoted to discussing and studying minority issues; 30% of the

programs involved in the study had students with little to no experience dealing with issues of

multiculturalism.

Institutions of higher education: course requirements. In researching the

requirements of three random universities that award degrees in the field of school psychology, it

was found that a small percentage of the required education for students in some programs are

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devoted to multiculturalism or cross-cultural service delivery knowledge, and in some cases,

none were required. The University of Arizona, the University of Minnesota, and the University

of Delaware each have advanced degree programs for the field of school psychology. To gain a

Ph.D. in school psychology at the University of Arizona, a student must complete 32 courses,

two of which pertain to multiculturalism. The courses are Cultural Diversity and School

Psychology, and Contemporary Issues in Bilingual School Psychology (University of Arizona,

2007). The University of Minnesota has different requirements for students completing doctoral

and master’s programs. According to the University of Minnesota, the program handbook lists

classes that must be completed in order to obtain a Ph.D. in School Psychology; however, not

one course specific to multicultural education is mandatory for graduation (University of

Minnesota, 2008).

The University of Delaware has a master’s program in school psychology which requires

the completion of 19 courses, all related to the field of school psychology, but none specifically

pertaining to multicultural education (University of Delaware, 2008). Only one of the three

universities requires a course on multicultural education. Although the sample of universities is

small, further research will show similar requirements, or lack of, in school psychology degree

programs.

A study conducted by Rogers, Ponterotto, Conoley, & Wiese (1992) found that 60% of

the doctoral and non-doctoral programs they surveyed offered one course specifically devoted to

multicultural issues, and 63% of those programs surveyed offered two to five courses. Seventy

five percent required at least one multicultural course to earn a school psychology degree.

Rogers et al. (1992) also found that 25% of the programs surveyed spent less than 5% of their

time on courses related to minority issues. Forty percent of the respondents indicated they did

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not spend any time on courses addressing a multicultural content, and most of the programs

(94%) did not require exposure to a second-language course. The results of a more recent study

by Kearns, Ford, & Brown, (2002) demonstrated that school psychology students had concerns

regarding their multicultural competence. Graduate students enrolled in APA accredited school

psychology programs were asked to identify areas they felt were weak in their programs.

Student’s responses indicated that learning about other cultures values and beliefs and how to

best provide school psychology services to underrepresented populations were areas of weakness

(Kearns, Ford, & Brown 2002).

Providing effective multicultural school psychologists will involve a continuous process

including multiple components promoting courses designed to shape a student’s cross-cultural

competencies, and as a whole, engraining a culturally broad approach to the field (Esquivel,

Lopez, & Nahari, 2007). According to Rogers et al. (1998) and Roger (1992), school

psychology students are currently trained with the theories and practices of Euro-American

Judeo Christian researchers. Without an increased emphasis on multicultural classes and cross-

cultural competencies, it is possible that graduates will enter their profession deficient in

providing effective school psychology services to certain underrepresented segments of the

student population (Rogers et al., 1992; Roger, 1998).

Cross-Cultural Curricula

School psychology curricula are non-uniform, especially in the area of cross-cultural

competency instruction (Carey & Reinat, 1990; Das, 1995; Tomlison-Clarke, 2000). While

some school psychology programs infuse multicultural concepts into all coursework, the

majority of programs teach the multicultural school psychology curricula through a single

semester-long course (Carey & Reinat, 1990; Das, 1995; Tomlison-Clarke, 2000). Currently, the

29

assessment methods, counseling techniques, consultation skills, and strategies in intervention

cater primarily to those of Euro-American descent (Zhou, Bray, Kehle, Theodore, Clark, &

Jenson, 2004).

In addition to limited cross-cultural course requirements for school psychology students,

there appears to be a disproportionate lack of experiential school psychology training with

underrepresented student populations (Loe and Miranda, 2005; Rogers et al., 1992). Rogers et

al. (1992) found 69% of program directors estimated that school psychology students were

exposed to minority clients less than a one-fourth of their time during practicum and internship

experiences. Loe and Miranda (2005) found that 20% of practitioners with 0 to 5 years of

experience had a culturally diverse experience during internship. Rogers et al. (1992) found that

almost one-third of the programs surveyed reported that school psychology students spend 0-5%

of their experiential training time with minority students. Loe and Miranda (2005) found 75.1%

of practitioners recommended increased exposure to diverse populations through practicum and

internships as a method to expand the cultural diversity training of school psychologists. One

could consider these results disturbing since the underrepresented student population in the

United States public schools system is now at 44.1% (NCES, 2007a). The concept that

professionals with knowledge and cross-cultural experiences are able to give better services to

clients from different cultures is what is called an efficacy claim (Frisby & Reynolds, 2005).

Fontes and Thomas (1996), maintain that supervised experience in a diverse population setting is

part of part of developing cross-cultural competence. The importance of cross-cultural curricula

for aspiring and current school psychologists is amplified due to the fact that a large percentage

of school psychology students have limited or no direct exposure to CLD clients during field

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training (Rogers et al., 1992). Experiencing such training may prove challenging in a culturally

homogenous geographic setting (Loe & Miranda, 2005).

The need for cross-cultural curricula for aspiring and current school psychologists is

urgent if the professionals in the field are committed to providing effective services to the entire

student population (Loe & Miranda, 2005; Rogers et al., 1992). With the changing

demographics occurring of the United States, psychology must make substantive revisions in its

curriculum, training, and practice (Rogers et al., 1992). Without these revisions, psychology will

risk professional, ethical, and economic problems because psychology will no longer be a viable

professional resource to the majority of the U.S. population (Hall, 1997).

Serving the South-East Asian Population

Considering the diverse ethnic/cultural makeup of the United States, it is important to

consider the methods and practice of any psychological service delivery discipline from each

ethnicity/cultural perspective (Knowles, 2006). It would be ideal to deliver the most effective

services to all clients in the United States. The North-American, European-American, Latin-

American, and African American ethnicities/cultures have, for the most part, adjusted to,

recognized, and embraced modern psychology and its many sub-disciplines (Knowles, 2006).

Brazil, for example, is noted as having the largest psychological association of any country, with

a population of 140,000 members (Knowles, 2006). However, Asia, specifically South-East Asia

is an area of the world where resident ethnicities/cultures have had minimal, if any, exposure to

the methods and concepts of modern psychology and its sub-disciplines (Knowles, 2006). It has

been suggested by some that the specific ethnicities/cultures of South-East Asia are so largely

different from any in the West that effective psychological service delivery for the population

comes with risks (Duan, Nilsson, Chia-Chih, Wang, Debemardi, Klevens, & Tallent, 2011).

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Western psychology was largely introduced to various Asian cultures in the 1940s. This

led to more recent renditions of psychology in specific areas of Asia today but the service

delivery is heavily influenced by Western ideals and values (Duan et al., 2011). Western

theories were learned in the West by Asian scholars and brought back to their home lands in Asia

to be practiced. These teachings of the West advanced the practice in the East; however, because

of the large difference in eastern and western cultures, the practice was problematic in that the

Asian populations did not embrace it (Duan et al., 2011). The practice of psychology continues

to change in the East to gain acceptance by the Asian populations (Duan et al., 2011). Scholars

argue that because culture is the root of human behavior and psychology, many current

psychological theories and practices may simply not be applicable to the South-East Asian

population (Wrenn, 1985). Additionally, Marsella and Pedersen (2004) point out the ideologies

of Western psychology such as individualism, rationality, and empiricism have limited meaning

and usefulness in the South-East Asian ethnicity/culture. Furthermore, Stevens (2002) adds that

the concept of applying a purely Western social science to the South-East Asian ethnicity/culture

is weak. Stevens (2002) also adds that human behavior is directly and indirectly related to the

cultural, religious, economic, and political variables of the society in which the discipline of

psychology is formed. To assume that the theories, ideals, concepts, and practices of western

psychology would be effective in delivering service to those of South-East Asian culture, without

massive overhaul on multiple levels, is irresponsible and reckless (Stevens, 2002).

Duan et al. (2011), comments that the concepts and practices of psychology are western

in nature. He adds the ideas of psychology truly need to change at a systemic level if we are to

deliver these services to South-East Asian clientele (Duan et al., 2011). A new perspective in the

discipline needs to be adopted recognizing that what the West considers practical psychological

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foundations and knowledge is not cross-cultural (Duan et al., 2011). Knowles (2006) adds to this

when he explains the need for developing new curriculum standards in academia and a balance

of the curriculum so it is inclusive of these new ideas and techniques. He also suggests that it

may be necessary to set new licensure standards and establish new ethical guidelines and

standards for continuing education in academia (Knowles, 2006).

As stated above, the roots of psychology and the history of school psychology have been

explored and identified as being Euro-American Judeo-Christian. These roots have shaped the

basic theories, philosophies, techniques, and mentalities of service providers in nearly every sub-

discipline of psychology in the western world (Frisby & Reynolds, 2005). The future of the

endorsement of modern psychology for this population will arise in the continent of Asia, which

is predicted to someday be the largest region of psychology in the world (Knowles, 2006). As

the concept of psychology expands in Asia, it is imperative that current and future service

providers are educated on the new theories and techniques that derive from this area. Doing so

will aid in providing effective service delivery for the Asian population in the United States

(Knowles, 2006). Knowles (2006) stresses this point when he explains the need for developing

new curriculum standards in academia and argues for a balance of the curriculum to make it

inclusive of these new ideas and techniques. Curriculum changes intended to better train

professionals in serving the mental health needs of the South-East Asian clientele will include

the training of professionals in school psychology.

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Chapter III: Methodology

This chapter describes the procedures and methodology that were used in conducting

research investigating mental health service delivery to South-East Asian clientele. The study

had two parts: a qualitative interview based on grounded theory and a quantitative electronic

survey. The first part of the study investigated the perceptions of South-East Asian professionals

in the field of mental health regarding the education of service providers to, and methods of

psychological service delivery to, clients of the South-East Asian ethnicity/culture. The second

part of the study investigated the perceptions of students currently studying the field of school

psychology regarding their level of formal education and competencies in providing effective

service delivery to the South-East Asian population of students in the public educational system

in the United States. This study will discuss the methodological aspects of both parts of the

study; research types, participants, survey instruments, data collection procedures and data

analyses.

Part One Methodology: Qualitative Research

Anderson (2006) describes qualitative research as, “…collecting, analyzing, and

interpreting data by observing what people do and say. Whereas quantitative research refers to

counts and measures of things, qualitative research refers to the meanings, concepts, definitions,

characteristics, metaphors, symbols, and descriptions of things” (p. 3). The nature of qualitative

research is subjective and primarily accomplished by collecting data from individuals or groups

of individuals through an interview process (Anderson, 2006). After the target sample is

interviewed, the responses, or data, are analyzed and, in some cases, categorized to identify

themes and trends that lead to further hypotheses. The quality of qualitative research is

contingent upon the skills, objectivity and methods of the person(s) gathering data. The positive

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aspect of this method of data gathering is that the information can yield rich in-depth information

about social and cultural issues and concepts (Anderson, 2006). “Quantitative research seeks

explanatory laws; qualitative research aims at in-depth description” (Anderson, 2006, p.3).

Qualitative research has strength in that it determines ‘how’ and ‘why’ evidence in

studies can be translated into certain practices as opposed to simply ‘what’ evidence is applied to

practice as is the case with quantitative research (Shuval, et al., 2011). Shuval et al. (2011) also

adds that qualitative research is very useful as it can lead to new explanations of certain concepts

and phenomena. If combined with quantitative research, both methods can enhance and expand

the findings and data, as more in depth reason and rationale can be attached to virtually any set

of data gathered (Shuval et al., 2011).

Grounded Theory Research

According to Mills, Bonner, and Francis (2006), grounded theory research is best

described as, “…a widely used qualitative research methodology that seeks to inductively distil

issues of importance for specific groups of people, creating meaning about those issues through

analysis and the modeling of theory” (p. 8). Smith, Flowers, and Larkin (2011) write,

“Grounded theory generally sets out to generate a theoretical-level account of a particular

phenomenon. This often requires work of considerable scale in comparison to other qualitative

approaches, and a very particular approach to sampling” (p. 43). They also add that, by nature,

the topic of grounded theory is not necessarily psychological in foundation; however, in many

cases its basis is psychological in phenomena (Smith, et al., 2011).

Grounded theory, as compared to other forms of data gathering, utilizes a general

sequence of steps to follow to gather data, consider and analyze data, and theorize based off that

data. Jones, Kriflik, and Zanko (2005) outline this process and describe three parts. The first

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part of grounded theory focuses on a social concern and begins with what researchers call open

coding, or, a stage where raw data is analyzed and organized in the form of a data gathering

instrument. Open coding widely considers data, as none is filtered and all is considered (Jones et

al., 2005). This allows researchers to look for, and identify, patterns that could be indicative of

social ideas or concepts that may be of particular interest. As the data is analyzed, trends begin

to emerge. The trends that are most clear are called core categories (Jones et al., 2005). After

the core categories are identified, the researcher can then determine which are most prevalent

and relevant to larger emerging concepts. Jones et al. (2005) writes about identifying core

categories and their relation to the interview process: “. . .only the most pertinent passages of a

transcript are used and coded, and to facilitate this, interview questions are continuously

reformulated to encompass the new and more focused direction of the research” (p. 8). The

final part of the grounded theory process, theoretical coding, occurs when theoretical saturation

has occurred, or, a point in which the ultimate concepts gathered from interviews and data

gathering are the same and no new data is being gathered from the collection process. The

ultimate goal of grounded theory is to identify an initial hypothesis about the topic being

explored (Jones et al., 2005).

Participant Selection

Participants in the first part of the study were four South-East Asian professionals in the

field of mental health. Three were from California and one was from Minnesota. All four

participants indicated they worked specifically with clientele of the South-East Asian

ethnicity/culture. Individuals who participated in the survey were selected through professional

referrals. Six were contacted and four accepted the interview.

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Survey Instrument

A ten question survey was designed by Carl Romstad, a graduate student, and research

advisor, Dr. Kevin Doll, to address the study’s research questions one through three. The survey

included questions that solicited input on the perceptions of South-East Asian professionals in

the field of mental health regarding: 1) the education of mental health professionals in areas

specific to the South-East Asian ethnicity/culture, and 2) the overall acceptance of mental health

practices and services by clients of the South-East Asian ethnicity/culture (see survey in

Appendix A). A “consent to participate” form (see Appendix C) was attached to the survey.

The survey instrument utilized an interview format data gathering device. Before using

the survey to gather data, it was reviewed and approved by the University of Wisconsin Stout’s

Institutional Review Board (IRB).

The purpose of the first three questions of the survey was to: establish the participant’s

current role as a mental health service provider, measure the level of education attained by the

service provider, and gather a general description of the courses required for that person to get

his/her degree.

The purpose of questions four and five of the survey was to: measure the level of

coursework the participants had received specific to mental health delivery to the South-East

Asian population, and measure the participant’s self-perceived level of competency, based on the

coursework received, to deliver mental health services to the South-East Asian population.

The purpose of questions six, seven and nine was to identify possible perceptions in the

South-East Asian culture regarding current psychology service delivery techniques and practices.

37

Questions eight and ten specifically sought the participants’ personal assessments of the

education being provided to students of psychology in relation to their South-East Asian culture.

Data Collection Procedures

The interview was sent out electronically for all participants to review. Two of the

participants completed and returned the survey and consent form via email. Two participants

were contacted as a follow up to the initial email and interviewed via telephone. Their consent

forms were gathered through the mail.

The two emailed interviews retrieved responses to the questions. The two interviews

conducted over the phone resulted in nearly exact responses, but left out filler words such as,

“um”, “ah”, “like”, and phrases such as, “let me think”, “let me see,” etc.

Data Analysis

After the four participants completed the interview, a point of theoretical saturation was

reached and four central themes were identified, supporting the initial concept. The four themes

were as follows:

1. The theories and methods of service delivery used by each of the professionals were

largely altered and changed to accommodate their South-East Asian clientele. The

alterations and changes were based off of their own cultural knowledge and new methods

learned through self education.

2. Some central themes and practices commonly learned and practiced in the field of

psychology were not accepted and considered taboo by the South-East Asian clientele

served.

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3. Based on each professional’s education alone, the theories and methods learned

pertaining to mental health service delivery were not fully applicable or practical for the

South-East Asian clientele he/she served.

4. Mental health service providers were not adequately trained to deliver services to South-

East Asian clientele and much more education about South-East Asian psychological

methods needed to be incorporated into the higher academic curriculum for those

entering the field of psychology.

The themes that emerged in the first part of the survey were used to construct a survey

instrument for part two.

Part Two Methodology: Quantitative Research

Anderson (2006) described quantitative research as, “…quantitative research refers to

counts and measures of things…” (p.3). Smith et al. (2011) added that quantitative research

explains associations between variables, numbers, and events. Also, the method of quantitative

research combined with qualitative research is very beneficial for research purposes. Qualitative

research combined with quantitative research can offer valuable insight as it can help interpret

the outcomes of results even further as opposed to using one of these methods alone (Smith et

al., 2011).

Participant Selection

The participants in the quantitative part of this study were students enrolled in higher

education programs that offered degrees in the field of school psychology. From May 9th, 2012

through May 19th, 2012, 85 School Psychology program directors from 10 different states were

emailed a survey and asked to forward it to the students in their programs who had completed

their first year and thereafter. The states included Arizona, California, Colorado, Illinois, Iowa,

39

Michigan, Minnesota, South Carolina, and Wisconsin, and they were selected based on the

prevalence of South-East Asian population in the state, and/or the prevalence of the school

psychology programs the state had to offer.

It is unknown which program directors specifically forwarded the surveys or which

specific schools each participant was from. 160 participants began the survey and 125

participants completed it. Participants were both male and female and had experience ranging

from first semester practicum to more than three years of experience in the school system.

Survey Instrument

A fourteen question survey was designed by the student researcher and the research

advisor, to answer research questions four through seven (see survey in Appendix B.). A

“consent to participate” (see Appendix D) was attached to the survey.

The first four questions of the survey included a tool called “Display Logic.” A “Yes”

response triggered question number two. A “No” response moved the participant directly to

question number three. The purpose of the first four questions was to measure the number of

participants who had taken multicultural and cross-cultural service delivery courses specific to

the South-East Asian culture as a requirement for earning their school psychology degrees.

Questions five through ten attempted to determine the participants’ assessment of the

level of training their academic program had provided to meet the needs of the South-East Asian

clientele, their self perceived competency levels in providing services to this population, and

their personal assessment as to how important it was to be educated to serve the needs of this

specific population. Responses to questions five, seven, and nine were asked on a five point,

Likert scale: 1 – Not at All; 2 – Somewhat; 3 – Fair Amount; and 4 – Very Much or: 1 – Not

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Important; 2 – Somewhat; 3 – Fair Amount; and 4 – Very Important. Questions five, seven, and

nine were each followed by an optional qualitative follow-up question, “Why? Please explain.”

Questions eleven through fourteen gathered demographic information that attempted to

determine the gender of the participant, the state of training, the number of years as a service

provider, and the aspired level of education.

Data Collection Procedures

The survey was distributed electronically to potential participants via a link contained in

an invitation email. Qualtrics, the University of Wisconsin Stout’s online survey software tool,

was utilized. It is unknown how many total potential participants received the invitation to

participate since the decision to forward the email invitation was made individually by each of

the 85 program directors contacted. Of those to whom the email invitation was forwarded, 160

chose to participate in the survey; 125 of those completed it. All data collected in the surveys

was used in the data analysis.

Data Analysis

The data was analyzed in two separate ways through the University of Wisconsin-Stout

Qualtrics program. Descriptive statistics were used to analyze the data using means, medians,

and standard deviations when applicable. Some of these questions also had optional follow-up

questions (i.e., “Why, Please Explain”). Qualitative data was gathered on those answers.

41

Chapter IV: Results

This chapter will present the results of survey research conducted in two parts. First,

information obtained through an interview style survey conducted in part one will be presented

as it relates to each of four themes. Following this, the data obtained from part two of this study

will be presented. Each set of results will be matched to the study research questions to which

the results apply.

Results of Part One: Grounded Theory

The objective of the research conducted in part one of the study was to identify themes

that might answer research questions one through three. The interview style survey solicited

input from South-East Asian professionals in the field of mental health regarding: the education

of mental health professionals in areas specific to the South-East Asian ethnicity/culture, and the

overall acceptance of mental health practices and services by clients of the South-East Asian

ethnicity/culture. After conducting the interview surveys in part one, four themes emerged. The

themes are considered the results of part one of the study research. The following sections list the

themes as they apply to the study’s research questions and the participant input that was

considered in identifying each theme.

Theme one. The theories and methods of service delivery used by each of the

professionals interviewed are largely altered and changed to accommodate their South-East

Asian clientele. The alterations and changes are based off of their own cultural knowledge and

new methods learned through self education. This theme provides results applicable to research

question one of the study.

The interviewees were asked questions about how well their education had prepared them

to deliver mental health services to the South-East Asian clientele they served. All interviewees

42

gave similar responses to the questions that contributed to identifying the first theme. One

participant said:

I feel that I cannot deliver the case management in part due to the education I received. I

feel that my time here, 20 years, has given me the knowledge to practice with SEA

clients. I was assigned to work with the SEA population due to the immigration influx

and the adjustment problems with the families (Interview participant #3, personal

communication, April 25, 2012).

Another added “I have to get information from different sources about Southeast Asian mental

health. I am adding books about the Hmong and articles about Southeast Asian mental health”

(Interview participant #1, personal communication, April 25, 2012). Based on the feedback, it

was evident that each professional had found it necessary to personally find ways to self-educate

on mental health service delivery to the South-East Asian and/or needed large amounts of field

experience with the Southeast Asian population in order to be effective.

Theme two. Some central themes and practices commonly learned and practiced in the

field of psychology are not accepted and are considered taboo by the South-East Asian clientele.

This theme provides results applicable to research question two of the study.

The responses from the interviewees that contributed to the second theme were numerous

and very informative. Interviewees pointed out that mental health as a whole is not fully

conceptualized and accepted in Asian countries as it is in the West. One respondent said, “I

believe, because I am in this field, I am comfortable about the topic and to talk about it. The

community and culture is still very uncomfortable with the stigma that goes with it” (Interview

participant #3, personal communication, April 25, 2012). Another respondent commented, “I

feel that counseling as a whole is taboo to the South-East Asian community. It is not a part of

43

the South-East Asian nature to share about their personal issues or difficulties” (Interview

participant #2, personal communication, April 25, 2012). Another stated, “Not necessarily

taboo, but due to lack of understanding it is not utilized. One thing that is big is that when

someone is seen as ill it is believed there is little chance for recovery” (Interview participant #4,

personal communication, April 25, 2012). In addition to the main concept of mental health being

less than appealing to the South-East Asian culture, additional specific topics were also

addressed.

Specific topics such as fear of being called “crazy” or given medication were some of the

concerns pointed out in the interviews. As written above, those seen as “crazy” could be cast out

of the community or considered incurable. One of the respondents stated:

Psychology in the US is based on Western conceptualizations of mental health. They

create rubrics for how to recognize certain mental health symptoms. Providers need to

use these rubrics carefully when working with South-East Asians because, for example, if

a South-East Asian client talks to the dead that does not necessarily mean that he or she is

delusional or hallucinating (Interview participant #1, personal communication, April 25,

2012).

She pointed out that the concept of ancestor worship, a very common practice in the many

different South-East Asian spiritualities/culture, may be misinterpreted. The fear of taking

medication is another concern according to the interviewees. One participant said there is quite a

bit of resistance to medication and a fear that medication will be administered if mental health

services are utilized. Another respondent said, “Taking medications for the mind is not accepted

and is even kind of scary that a person would be asked to do that” (Interview participant #1,

44

personal communication, April 25, 2012). This theme was made very clear and appeared as a

significantly strong one.

Theme three. Based on each professional’s education alone, the theories and methods

learned pertaining to mental health service delivery were not fully applicable or practical to the

South-East Asian clientele he/she serves. This theme provides results applicable to research

question three of the study.

The interviewees were asked to answer questions that pertained to their education and

how the fundamental principles of their learned skills applied to serving their South-East Asian

clientele. One participant said:

There was nothing specific that was a part of the curriculum that was taught in regards to

working with South-East Asian. . . The learning of various counseling skills was valuable

(i.e., humanistic approach, CBT); however, it is difficult to apply in sessions with South-

East Asian clients, as they value the extended family and have trouble working on

individual problems (Interview participant #2, personal communication, April 25, 2012).

Another made a definite statement when asked if the education he received was applicable to

servicing the South-East Asian clientele he served. He responded, “Absolutely not. The training

was insufficient to do that at all.” (Interview participant #4, personal communication, April 25,

2012). Another participant gave a specific example of how being trained in western psychology

impacted her in one professional situation when she stated:

Another issue is that South-East Asian providers are trained in trained in the Western

institution of mental health, which does not take into consideration South-East Asian

mental health systems. In fact, just two weeks ago, I talked to a few professionals about

somatization and they laughed, stating that practitioners sometimes make a huge stretch

45

trying to group South-East Asian symptoms to fit into Western mental health categories

(Interview participant #1, personal communication, April 25, 2012).

Ultimately, all the respondents believed that the information they learned from traditional classes

was very impractical for their South-East Asian clientele.

Theme four. Mental health service providers are not adequately trained to deliver

services to South-East Asian clientele and much more education about South-East Asian

psychological methods needs to be incorporated into the higher academic curriculum to

adequately serve this population. This theme provides results applicable to research question

three of the study.

Details gathered from the interviews were the basis of theme four. Each of the

participants was of the South-East Asian ethnicity/culture. Each one expressed some level of

frustration and difficulty using Western social science methodologies on an Eastern population.

The cause of this frustration ultimately lies in the education required of those in the many

different professions of mental health service delivery. One respondent commented:

Again, the field is dominated by whites who do not take into consideration the needs or

perspectives of other cultures… Definitely I think we need to include more information

about the mental health needs of different cultures when training future practitioners…I

can’t talk for other professionals, but in my view I believe it is very draining to work so

hard to adjust the Western system to fit client needs so at times I feel as though it is futile

because we do not get system wide support (Interview participant #1, personal

communication, April 25, 2012).

A second respondent said, “I think it would be invaluable to have specific learning from different

spiritual healing practices or have a field placement site include spiritual centers (i.e, shaman,

46

Buddhist temples)” (Interview participant #2, personal communication, April 25, 2012).

Another respondent stated, “In terms of providing services to the South-East Asian population, it

is very different than the western ways. The two groups are very different and education is key

to help bridge this cultural gap or lack of knowledge. The western methods just do not fit”

(Interview participant #4, personal communication, April 25, 2012). A final respondent said, “In

my experience, we need to see more education in the area of mental health and how to deliver it

to others in my culture” (Interview participant #3, personal communication, April 25, 2012).

Of special interest was a statement made by one of the interviewees. She stated, “In my

experience we need to see more education in the area of mental health and how to deliver it to

others in my culture. I myself and many others would rather go to a person that is not of the

South-East Asian culture. We feel that we are being judged by those that are of this culture

versus those that are not” (Interview participant #3, personal communication, April 25, 2012).

The respondent made the point that there may be an element of distrust to see a service provider

that was of the South-East Asian ethnicity/culture for fear of judgment by that person and fear

that that person may breach confidentiality to the South-East Asian community, depending on

what was revealed by the client.

Emerging themes from part one of the study indicate that one solution to providing

effective mental health services to the South-East Asian population would be to add content to

the curricula required of those seeking degrees in the mental health field. A general fear of

mislabeling and misunderstanding seems to be prevalent in the South-East Asian

ethnicity/culture in regards to seeking mental health services; and, according to one participant,

the answer relies solely on education of the providers and not simply placing a practitioner of the

South-East Asian ethnicity/culture in front of a South-East Asian client.

47

Results of Part Two: Quantitative Survey

The objective of the research conducted in part two of the study was to gather data to

answer research questions four through seven. The fourteen question survey, developed after

identifying the themes of concern in part one, sought to identify the level of academic

preparation in South-East Asian ethnicity/culture, and the level of competence in cross-cultural

service delivery to the South-East Asian population in the public education system. After

closing the survey and analyzing the results, the data was categorized to answer research

questions four through seven of this study. Each research question is followed by the relevant

data collected in the online survey.

Research question four. Do school psychology students have knowledge of cross-

cultural school psychological service delivery methods for the South-East Asian

ethnicity/culture?

Current school psychologists-in-training were asked questions pertaining to their level of

cross cultural service delivery knowledge in the field of school psychology, and specifically,

their level of knowledge in delivering services to the clientele of the South-East Asian

population. When asked if they were required to take any courses that would train them in cross-

cultural service delivery techniques to obtain their degree, 89 (64%) responded “Yes” and 51

(36%) responded “No” (see Table 1). Fifteen did not answer. The participants who answered

“Yes” were then asked if those courses in the area of cross-cultural service delivery specifically

covered techniques pertaining to the South-East ethnicity/culture. Of those who responded, 28

(36 %) responded “Yes” and 50 (64 %) responded “No” (see Table 2). Eleven did not answer.

48

Table 1

Were you required to take any cross-cultural service delivery courses (any class formally educating you about psychological service delivery techniques of other ethnicities/cultures) to gain your degree or be approved for service delivery?

Response Frequency Percent Valid Percent Cumulative Percent

Valid Yes 89 57.4 63.6 63.6

No 51 32.9 36.4 100.0

Total 140 90.3 100.0

Missing did not answer 15 9.7

Total 155 100.0

Table 2

If yes, did you learn about service delivery techniques specific to South-East Asian clientele?


Valid Yes 28 18.1 35.9 35.9

No 50 32.3 64.1 100.0

Total 78 50.3 100.0

Missing n/a 51 32.9

did not answer 11 7.1

did not answer branching question

15 9.7

Total 77 49.7

Total 155 100.0

49

Research question five. Do school psychology students have formal training in the

South-East Asian Ethnicity/Culture?

When current school psychologists in-training were asked if they were required to take

any courses that formally educated them about other cultures to obtain their degree, 128 (83 %),

participants responded “Yes” and 27 (17 %) responded “No” (see Table 3). Furthermore, when

asked if these courses specifically taught them about the South-East Asian ethnicity/culture 60

(53 %) participants responded “Yes” and 54 (48 %) responded “No” (see Table 4). Fourteen did

not answer.

Table 3

Were you required to take any multicultural courses (any class formally educating you about other ethnicities/cultures) to gain your degree or be approved for service delivery?


Valid Yes 128 82.6 82.6 82.6

No 27 17.4 17.4 100.0

Total 155 100.0 100.0

50

Table 4

If yes, did you learn about the South-East Asian ethnicity/culture?


Valid Yes 60 38.7 52.6 52.6

No 54 34.8 47.4 100.0

Total 114 73.5 100.0

Missing n/a 27 17.4

did not answer 14 9.0

Total 41 26.5

Total 155 100.0

Research question six. Do school psychology students feel comfortable/have the ability

to implement service delivery methods to the South-East Asian culture?

Current school psychologists in-training were asked to what degree they felt competent

and/or able to deliver school psychological services to the South-East Asian population based on

the classes taken and formal training they received in academia. They were also asked to

illustrate their answer further with an optional “Why? Please explain” question following.

Participants were also asked to rate how well their training program had educated them on

service delivery methods that are specific to the South-East Asian ethnicity/culture. Thirty-five

(29 %) participants rated their program as having educated them “Not At All” well, 65 (54 %)

rated their program as having educated them “Somewhat” and 21 (17 %) participants rated their

program as having educated them a “Fair Amount” (see Table 5). Thirty-Four did not answer.

Descriptions of the optional follow-up question will be discussed in the following chapter.

Participants were then asked to rate how prepared they felt to provide school psychological

51

services to South-East Asian clientele. Nineteen (16 %) participants rated themselves as “Not At

All” prepared, 64 (53 %) participants rated themselves as “Somewhat” prepared, 34 (29 %)

participants rated themselves as “A Fair Amount” prepared, and 4 (3 %) participants rated

themselves as “Very Much” prepared (see Table 6). Thirty-four did not answer. Respondents

were also asked to explain their answer further with an optional “Why? Please explain” question

following. Results of the optional follow-up question will be discussed in the following chapter.

Table 5

Please rate how well your program has educated you on psychological service delivery techniques to clients who are specifically of the South-East Asian ethnicity/culture.


Valid Not At All 35 22.6 28.9 28.9

Somewhat 65 41.9 53.7 82.6

Fair Amount 21 13.5 17.4 100.0

Total 121 78.1 100.0


Total 155 100.0

52

Table 6

Please rate how prepared you feel to deliver school psychological services to those who are of the South-East Asian ethnicity/culture.


Valid Not At All 19 12.3 15.7 15.7

Somewhat 64 41.3 52.9 68.6

Fair Amount 34 21.9 28.1 96.7

Very Much 4 2.6 3.3 100.0

Total 121 78.1 100.0


Total 155 100.0

Research question seven. Do school psychology students find it important to use cross-cultural

service delivery methods for the South-East Asian culture?

Current school psychologists in-training were asked to rate the level of importance in

being trained for different methods of cross-cultural service delivery in the field of school

psychology, specifically those that pertained to the South-East Asian ethnicity/culture. Two (2

%) rated the level of importance as “Not Important,” 27 (22%) rated the level of importance as

“Somewhat Important,” 50 (41 %) rated the level of importance as “Fairly Important,” and 42

(35 %) rated the level of importance as “Very Important” (see Table 7). Thirty-four did not

answer. Participants were also asked to illustrate their answer further with an optional “Why?

Please explain” question following. Results of the optional follow-up question will be discussed

in the following chapter.

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Table 7

Please rate how important you think learning about different methods and ideas of psychological service delivery are, specifically those of the South-East Asian ethnic/cultural perspective.


Valid Not Important 2 1.3 1.7 1.7

Somewhat 27 17.4 22.3 24.0

Fair Amount 50 32.3 41.3 65.3

Very Important 42 27.1 34.7 100.0

Total 121 78.1 100.0


Total 155 100.0

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Chapter V: Discussion

This chapter will summarize the findings of this research project. This study utilized two

methods: 1) a qualitative grounded theory approach to identify the main themes of concern in the

field of psychology relative to service delivery to the clientele of the South-East Asian

population; and 2) a quantitative survey constructed and distributed to current school

psychologists in-training as a follow-up to information gathered from part one of the research

study, with a qualitative option to substantiate rationale for answering questions in a specific

manner. This chapter will summarize the important findings of the study, discuss the overall

findings and link those findings to literature that surrounds this issue. The chapter will conclude

with a discussion of the limitations of the study, implications for future research, implications for

practice, and a summary of the study.

Part One: Important Research Findings

Four mental health service providers of the South-East Asian ethnicity/culture who also

served clients of their culture were interviewed to gather information relative to research

questions one through three (see pages 13 - 14.) The findings of that research resulted in

identifying four themes in response to part one of the study.

Effectiveness of psychology practices relative to clients of south-east Asian

ethnicity/culture. The following, theme one, is applicable to research question one of the study:

- Theories and methods of service delivery used by each of the professionals interviewed

are largely altered and changed to accommodate their South-East Asian clientele. The

alterations and changes are based off of their own cultural knowledge and new methods

learned through self education.

Acceptance of psychology practices by clients of south-east Asian ethnicity/culture. The

following, theme two, is applicable to research question two of the study:

55

- Some central themes and practices commonly learned and practiced in the field of

psychology are not accepted and are considered taboo by the South-East Asian clientele.

Academic preparation of psychology professionals relative to serving the south-east

Asian population. The following, themes three and four, are applicable to research question

three of the study:

- Based on each professional’s education alone, the theories and methods learned

pertaining to mental health service delivery were not fully applicable or practical for the

South-East Asian clientele.

- Mental health service providers are not adequately trained to deliver services for South-

East Asian clientele, and much more education about South-East Asian psychological

methods needs to be incorporated into the higher academic curriculum for those entering

the field of psychology to serve this population.

These findings, the themes of part one of the study, suggest that those in training in the field of

school psychology will need to acquire specific skills to effectively serve the South-East Asian

population.

Part Two: Important Research Findings

Level of training provided to school psychologists to prepare them as service

providers for those of south-east Asian ethnicity/culture. Questions one through four of the

survey addressed research questions four and five (see page 14). According to the data gathered

in questions one and two of the survey, of the 155 participants, 128 (83 %) said they were

required to take a multicultural class to earn their degrees to become a school psychologist. Of

that number, 60 indicated they had learned about the South-East Asian ethnicity/culture as part

of that requirement. These findings indicate that only 38% of the school psychologists in-

56

training had been educated about the South-East Asian ethnicity/culture. In addition, according

to the data gathered in questions three and four of the survey, 89 (64 %) had been required to

take a cross-cultural service delivery course as a requirement to earn their school psychology

degrees. Of that number, 28 indicated that as part of that requirement they had learned about

service delivery techniques specific to the South-East Asian ethnicity/culture. These findings

indicate that only 20% of the school psychologists-in-training had been trained in service

delivery techniques for those of South-East Asian ethnicity/culture.

Self perceived confidence levels of school psychologists in-training, to deliver

services to south-east Asian ethnicity/culture. Questions five through eight of the survey

addressed research question six (see page 14). In survey question number five, participants were

asked to rate how well their program had educated them to provide services for South-East

Asians. Participants were given the option of selecting “Not At All,” “Somewhat,” “Fair

Amount,” and “Very Much.” One hundred and twenty one participants responded. Of this

number 35 (29 %) responded “Not At All,” 65 (54 %) responded “Somewhat,” and 21 (17 %)

said “Fair amount,” and none (0%) responded “Very Much.” After selecting their answers,

respondents went on to further explain their responses in question six.

Of the 35 participants who responded “Not At All,” 12 went on to substantiate their

answers. Of the 12, 3 indicated no courses were taken in service delivery preparation; 4 reported

courses were taken but were broad and not specific to the South-East Asian ethnicity/culture; and

5 stated different ethnicities/cultures were covered in terms of cross-cultural service delivery

education, but the South-East Asian ethnicity/culture was not one of them.

The next group of respondents selected “Somewhat” as an answer to question number 5.

Of the 65 who did, 37 went on to substantiate their answers. Of the 37, 10 indicated a formal

57

class was taught on South-East Asian ethnicity/culture in regards to psychological perspectives

and concepts in relation to the culture, (these formal classes were up to two days in length) and

27 reported the idea of ethnic/cultural awareness was touched on and, in some cases, the South-

East Asian ethnicity/culture was covered.

The final set of respondents selected “Fair Amount” as their choice to this question. Of

the 21 who did, 9 went on to substantiate their answers. Of the 9, 6 indicated that multicultural

courses were taken and the South-East Asian ethnicity/culture was addressed during a lecture or

a specific assignment given by the instructor; 1 stated that the instructor of a course was of the

South-East Asian ethnicity/culture; and 2 reported that ethnic/cultural sensitivity was engrained

in the courses taken. The findings of questions five and six indicate that the majority (83%) of

respondents considered their level of academic preparation to serve the South-East Asian

population as less than a “Fair Amount.”

In question number seven, participants were asked to rate how personally prepared they

felt they were to deliver school psychological services to those of the South-East Asian

population. Participants were given the option of selecting “Not At All,” “Somewhat,” “Fair

Amount,” and “Very Much.” Of the 121 participants who responded to the question, 19 (16%)

responded “Not At All,” 64 (53%) responded “Somewhat,” 34 (28%) responded “Fair Amount,”

and 4 (3%) responded “Very Much.” After selecting their answers, 50 respondents further

substantiated their responses to question eight.

Of the 19 participants who responded, “Not At All,” 6 went on to substantiate their

answers. All 6 of the respondents indicated they had not learned about how to deliver school

psychology services to the South-East Asian ethnicity/culture.

58

Of the 64 participants who responded “Somewhat,” 20 went on to substantiate their

answers. One of the 20 indicated that preparation is about practice, not education about different

ethnicities/culture; 9 reported that the preparation they received was minimal to none at all and

more education is needed in this area; 4 stated that they believed the service delivery education

they received would transcend cultures and guide their self education if need be; and 4 responded

that the courses taken had taught them how to self educate and how to be ethnically/culturally

sensitive.

Of the 34 participants who responded “Fair Amount,” 20 went on to explain their

answers. Of the 20, 4 participants reported that learning about psychological service delivery

methods specific to the South-East Asian ethnicity/culture may only be important some of the

time as most skills learned will transcend all cultures; 2 responded that although the skills needed

to give effective services to this population aren’t specifically known, they can be learned if

necessary in the future; and 3 responded that he/she had either spent time domestically or abroad

in some area of South-East Asia or they themselves are of this ethnicity/culture.

Four of respondents selected “Very Much” as an answer to this question and all 4 went

on to substantiate their answers. Of the 4, 3 reported they had spent time in South-East Asia or

were of the South-East Asian ethnicity and 1 individual felt prepared to deliver services to all

ethnicities/cultures based on his/her education received and knew how to seek out information if

need be.

Based on the information gathered both quantitatively and qualitatively one could

observe five themes in response to the sixth research question.

The themes were as follows:

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- Respondents had nonsufficient education and the respondents’ lack of education and

level of preparation made them ill-prepared to delivery school psychology services

for the South-East Asian population of students.

- Respondents received minimal formal training about perspectives and concepts of

psychology from the South-East Asian ethnicity/cultural perspective. This formal

training was less than, or equal to, two class periods in length.

- Respondents learned sensitivity to the South-East Asian ethnicity/culture via in-class

video/popular culture film screening and/or assigned reading.

- Respondents felt that the skills they had learned were sufficient and they would self

educate on different cultures if they felt necessary.

- Respondents had some level of personal involvement with the South-East Asian

ethnicity/culture through domestic/abroad experience or they themselves were of the

ethnicity/culture and considered those circumstances to be sufficient preparation.

The themes often spanned the different questions. For example, not all of the participants who

gave responses claimed they were ill prepared to deliver services chose the answer “Not At All”

for questions 5 and 7 while completing the survey. Some felt that being ill prepared still placed

them in the “Somewhat” category, and some felt it placed them in the “Not At All” category.

Some respondents felt that learning about sensitivity issues and knowing how to self educate

justified a choice of “Somewhat,” while others felt this justified a “Fair Amount” and even a

“Very Much” response. Personal perceptions of one’s education and level of preparation were

subjective and varied among the respondents. Of the five different themes identified, two

referenced formal classroom training pertaining to the South-East Asian ethnicity/culture. One

theme indicated an absence of any training in this area; a second theme indicated minimal formal

60

training. The theme that suggests there was some sort of formal education is derived from

respondents indicating they learned about perspectives and concepts of psychology in relation to

the South-East Asian ethnicity/population in one or two lectures. The remaining three themes

pertained to sensitivity training, personal experience, abilities to decide what is important, when

to self educate and the concept that methods transcend culture.

Findings from questions seven and eight indicate that the majority of respondents (69%)

considered their level of preparedness to deliver school psychology services to the South-East

Asian population to be less than a “Fair Amount,” and indicated the training was minimal and

mostly informal.

School psychologists’ in-training perceptions of the importance of cross-cultural

service delivery to clients of south-east Asian ethnicity/culture. Survey questions nine and

ten addressed research question seven (see page 15). Participants were asked to rate how

important they felt it was to have knowledge of and use cross-cultural service delivery methods

with the South-East Asian population. Of the participants involved in the study, 121 responded.

Of this number, 2 (2%) responded “Not At All,” 27 (22%) responded “Somewhat,” 50 (41%)

responded “Fair Amount,” and 42 (35%) responded “Very Important.” After selecting their

answers, respondents went on to further substantiate their responses in question ten.

Of the 2 participants who responded “Not At All,” both went on to substantiate their

answers. They indicated there was not enough time to worry about specific cultures, thus there

was no discussion necessary.

Of the 27 participants who responded “Somewhat,” 10 went on to substantiate their

answers. Of the 10, 8 indicated that education for this group is only necessary if you are working

61

directly with them; and 2 reported that it is important to learn about all ethnicities/cultures, and

this one is no more or less important.

Of the 50 participants who responded “Fair Amount,” 20 went on to substantiate their

answers. Of the 20, 4 reported that it is important to learn to service the South-East Asian

population because respondents serve this population currently; 6 indicated it is only important if

this is a large enough population that needs to be served; and 10 stated it is important to know

how to provide service delivery to everyone, not just the South-East Asian population.

The final group of respondents selected “Very Important” as their response to question

number nine. Of the 42 participants who responded, 22 went on to further substantiate their

answers. All 22 indicated it is important for any school psychologist to know about a client’s

ethnicity/culture as this will help in service delivery.

The findings of questions nine and ten indicate that the majority of respondents (i.e.76%)

considered learning about cross-cultural service delivery for clients of South-East Asian

ethnicity/culture to be “Fair Amount” to “Very Much” important, and it is especially important if

the person served clientele of that ethnicity/culture.

Overall Findings

Results of part one of this research indicated that mental health professionals of the

South-East Asian ethnicity/culture believe their unique culture is not represented in academia in

terms of service delivery technique training. They also feel that much work needs to be done to

create an atmosphere in which the South-East Asian population of the United States will accept

mental health services and will actively seek them. According to one of the participants, an

influx of South-East Asian service providers may not be the optimum resolution to the problem

as it would actually be less appealing to the population for cultural reasons.

62

Results of part two of the study indicated a substantial gap exists between the education

and knowledge school psychologists in-training felt they would need to serve the South-East

Asian clientele and what they had received or were required to receive to obtain their degrees.

The majority of respondents 92 (76%) indicated that it is “Fairly” to “Very” important to have

cross-cultural knowledge relative to serving the South-East Asian ethnicity/culture, whereas only

38% of respondents took a multicultural course that specifically educated them about the South-

East Asian population. In addition, only 20% took a cross-cultural service delivery course

specifically designed to educate them about service delivery methods and techniques for the

South-East Asian population.

Results from part two of the study indicated most school psychologists in-training

considered themselves unprepared to delivery services for the South-East Asian population of the

public school system. The majority of respondents (83%) said that their level of academic

preparation to serve the South-East Asian population was less than a “Fair Amount.” Sixty-nine

percent rated their level of preparedness to deliver school psychology services to the South-East

Asian population to be less than a “Fair Amount.” Those school psychology respondents who

indicated they were “Very Much” prepared to deliver school psychology services for the South-

East Asian population did so based on several beliefs. Some believed they had the knowledge to

personally educate themselves if necessary. Some believed the general skills they learned would

transcend ethnicities and cultures, thus making education specific to a certain ethnicity/culture

unnecessary. Several had learned about ethnic/cultural sensitivity, and/or had personal ties to, or

experiences with, the South-East Asian ethnicity/culture, thereby making them prepared to

deliver services for that population. Among those, 19% of the survey participants who rated

themselves as “Not At All” prepared to deliver school psychology services to the South-East

63

Asian population, most indicated they had taken a brief course on the topic and felt there was

much more to learn to provide effective services in every area essentially recognizing their limits

and the need for more education. The results of part two of this study indicate that the majority

of the school psychologist-in-training believed education specific to the South-East Asian culture

is important, and the minority reported they are ready to deliver services based on their personal

perceptions of skills, not formally taught ones.

The results of parts one and two of this study are consistent with research by Duan, et al.

(2011), Knowles (2006), Roger, Hoffman and Wade (1998), and Stevens (2002), which suggest

that the current curriculum in academia that is educating and preparing professionals in all fields

of psychology is ethnically and culturally deficient and is in need of re-evaluation if it is to be

applied to specific clientele such as the South East Asian population. Also, the information from

this survey is consistent with research by Duan, et al. (2011), Knowles (2006), Roger, Hoffman

and Wade (1998), and Stevens (2002) in that level of preparation to deliver services to the South-

East Asian population is minimal, at best, and much more is needed at an academic level to

adequately prepare future professionals in the field of school psychology.

Duan et al. (2011) suggested that there is great difference between Western psychology

and Eastern psychology. Sixty-four percent of the participants in part two of the study indicated

they had received no training specific to service delivery to the South-East Asian

culture/ethnicity. With no such training, these professionals will likely be implementing Western

concepts and ideals, believing they will likely be effective when serving those of the South-East

Asian population (Knowles, 2006). Stevens (2002) suggested that this mentality is, to say the

least, very unlikely to be effective. Knowles (2006) also suggests that while other countries and

ethnicities/cultures have embraced the idea of Western psychology and flourished with it, the

64

South-East Asian population has not embraced it because of cultural reasons. Duan et al. (2011)

supported this point of view suggesting that any social science, psychology (school psychology

being one of them), is based on political, spiritual, economic, and philosophical ideals. As such,

this exclusively Euro-American Judeo-Christian social science would need massive overhaul to

work for the largely different South-East Asian population. Sue and colleagues (2007)

concluded by saying that the ethnic/cultural bias of this discipline is something that is very real

and it needs to be addressed at an academic systemic level if it is to ever change.

Limitations of the Study

There are limitations to both parts of this study that must be considered when analyzing

these results. In the first part of the study, the sample size was small, consisting of four mental

health professionals of South-East Asian ethnicity/culture. While six professionals were invited

to participate in the study, only four participants responded. Finding South-East Asian mental

health professionals to respond to the survey was an initial challenge. It is unknown whether the

number of mental health professionals of South-East Asian ethnicity/culture is small and/or if

access to them was limited due to geographic or cultural boundaries. Because the responses of

the four who participated were very similar, one could infer that expanding the number of

participants in part one of the study would not alter the results, however, this cannot be assumed.

A greater limitation of the study is that specific sub-cultures of the South-East Asian individuals

interviewed were not identified. A study that identified and included numerous sub-cultures of

the South-East Asian ethnicity/culture might yield more generalized results.

Part one of the study surveyed mental health professionals serving the South-East Asian

population. It did not specifically survey school psychology professionals of South-East Asian

ethnicity/culture. It is unknown if the effectiveness of the techniques and training of school

65

psychologists, when applied in a school setting, would be evaluated differently by school

psychology professionals of the South-East Asian ethnicity/culture.

In the second part of the study, only 125 of the 160 participants finished it. One might

question if the survey instrument itself was unclear or cumbersome, resulting in an almost 25%

dropout rate. All participants had completed a minimum of one year of study. If the participants

had all been recently awarded their degrees, the results may have varied since additional

coursework and/or experiential requirements could have occurred after the date of the survey and

prior to full licensure, resulting in altered responses. The participants in the second part of the

study were not identified by ethnicity or culture. Gathering this data may have provided

additional information for the study

Much more research would need to be done to draw solid conclusions about the trends in

academia and whether current school psychology training and practice can be useful to South-

East Asians and other non Euro-American Judeo-Christians ethnicities and cultures. With so

many different cultures and sub-cultures in the United States public school system population, it

is unrealistic to expect that expanding the multicultural scope would result in acceptance of the

services provided by all members of the population.

Implications for Future Research

Currently academia offers, and in some cases, requires multicultural and cross-cultural

courses for school psychologists in-training. As this study indicates, these courses might be

considered insufficient in preparing future practitioners to effectively deliver services to those of

non Euro-American Judeo-Christians cultures/ethnicities, and specifically those of the South-

East Asian ethnicity/culture. It would be beneficial to conduct future research on the practicality

and possible outcomes of curricula designed specifically for cross-cultural service delivery for

66

different ethnicities or cultures. Multicultural courses may be more beneficial to the students if

the range of instructors possessed a majority of credentials in the fields of sociology and

anthropology, in addition to psychology. Shaping coursework on the impact of human behavior

and sociological perspectives on modern psychological practices might be one approach.

Specific courses designed to educate professionals-in-training on the sociological foundational

differences of ethnicities/cultures such the South-East Asian ethnicity/culture and how it pertains

to their concepts and perceptions of the practice of mental health services, specifically school

psychology, might be of extreme benefit.

Implications for Practice

Currently, school psychologists-in-training are taught diversity through multi-cultural

courses. Aspiring professional are very aware that there are many cultures/ethnicities

represented in the population of the public school system. Being aware of the diversity of that

population does not guarantee effective service delivery for the population. The education

school psychologists-in-training are receiving has its roots exclusively in the Euro-American

Judeo-Christian ethnicity/culture (Behring & Ingraham, 1998). This study has shown that a

small percentage of those being trained in the field are taking courses related to cross-cultural

training and service delivery methods specific to the South-East Asian ethnicity/culture. As

Knowles (2006) writes, the overall discipline of psychology has been modified to better fit other

cultures, and as a result of this, psychology has been embraced and has thrived in them.

Knowles (2006) also adds that these cultures are the ones more closely related to the Euro-

American Judeo-Christian ethnicity/culture through similar spirituality, political, and other social

concepts making this retro-fitting much easier for each. Given the enormous contrast of the

67

South-East Asian ethnicity/culture and the Euro-American Judeo-Christian ethnicity/culture, this

retro-fitting comes with more risks than benefits (Duan et al. 2011).

This information suggests that practicing school psychologists will benefit from re-

evaluating nearly all the techniques they have learned and understanding that they may not

transcend all cultures and, if applied to certain populations such as the one in this study, may

come with risks. Further education in new theories and techniques for the South-East Asian

population will benefit school psychologists in the field and training as well as the clientele of

this ethnicity/culture. Gergen, Gulerce, Lock, & Misra, (1996) suggested that until training

becomes absolutely specific to each ethnicity/culture and its norms and practices, a service

provider must consider every situation as different and evaluate the needs of the client based on

the values, motives, and beliefs specific to that culture. Also, a practitioner believing he or she is

competent in serving those they have not been trained to serve may practice unethically and in

the client’s least interest (Gergen et al., 1996).

Summary

It is clear that from the literature reviewed and the research conducted that there is a

substantial gap in what is expected of school psychological service providers and the level of

preparation for the effective service delivery for the South-East Asian ethnicity/culture. School

psychologists-in-training learn skills that help them work with other professionals, conduct

interventions, and communicate effectively with parents, professionals, and clients (Martines,

2008). These programs often fail to teach similar skills for cross-cultural situations (Martines,

2008). This is further illustrated by the fact that, regardless of the advocacy for cross-cultural

curricula in school psychology, only one or two courses are offered to aspiring professionals

(Martines, 2008).

The importance of cross-cultural school psychology is gaining attention and change will

68

be necessary in two areas: 1) increasing cross-cultural experiences for students of the discipline,

and 2) changing theories, practices and techniques taught in the schools of the discipline. Keen

(2001) wrote,

It is perhaps possible now, with the coming of postmodern thought that the cleansing

science of values, insisted on by those who see science as beyond the influence of

historical rhetoric, can be over. To see the rhetorical nature of psychology is to put

psychology into a different historical narrative than the modern one of self-correcting,

universal, and objective science. It is time to revise our theory. I wonder if good

clinicians have not always known this (p. 239).

The path to cross-cultural school psychology ultimately depends on academia.

Reevaluation of current theories and practices in school psychology is important for the

discipline’s future of serving the South-East Asian population and any other cultures/ethnicities

whose philosophies do not align with the current theories and techniques of the discipline. Until

such reevaluation takes place and coursework and experiential training requirements include

those of cross-cultural content, it could be determined that school psychology cannot be

considered a science that can be effectively be applied to all clientele in the public school

system.

The findings of this study indicate, and previous research underscores, the significant

need for more cross-cultural education specific to the South-East Asian population, to ensure

effective school psychology service delivery for this population in the public education system.

69

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Appendix A: Grounded Theory Interview

Survey Instrument 1: Grounded Theory Interview

1. What is your official job title as a service provider in the field of mental health

2. What level of education did you obtain to become a certified practitioner?

3. Do you recall the courses you were required to take to gain your degree in your field? Courses can be general ideas and memories, or you may not recall.

4. Do you recall any courses in your educational experience that required you to learn about psychological service delivery methods that were specific to South-East Asian individuals considering cultural values, spiritual beliefs, etc? If yes, give detail.

5. Do you feel you are able to deliver services to the South-East Asian clientele you serve based solely off your training you received in academia? If no, what are you doing to add to your education to serve the South-East Asian clients you are serving?

6. If you are comfortable answering, what is your cultural belief/standpoint on mental health service delivery and/or any discipline of psychology practiced in the United States?

7. Are there any common learned psychological practices that you can think of that are seen as taboo or not accepted in your culture? If so, please give as much detail as possible.

8. Do you feel your cultural belief/standpoint on mental health service delivery and/or psychology was/is represented in the education of future and current service providers?

78

9. Given the average methods of practitioners, do you feel there are any individuals of your culture that may not want to engage in mental health service delivery? If so please explain.

10. As you know the purpose of this survey is to find out if the education given today to future mental health service providers is inclusive of the ethnicity/culture of the South-East Asian population in the United States. This would include any cultural/ethnic values, practices, and spiritual beliefs. Is there anything you would like to add or are there any ideas or thoughts that have come to mind in relation to this during the interview?

79

Appendix B: Quantitative Data Gathering Survey

Survey Instrument 2: Quantitative Data Gathering Survey

Q1 Were you required to take any multicultural courses (any class formally educating you about other ethnicities/cultures) to gain your degree or be approved for service delivery?

Yes (1) No (2)

Answer If Were you required to take any multicultural courses (any ... Yes Is Selected

Q1 If yes, did you learn about the South East Asian ethnicity/culture?

Yes (1) No (2)

Q2 Were you required to take any cross-cultural service delivery courses (any class formally educating you about psychological service delivery techniques of other ethnicities/cultures) to gain your degree or be approved for service delivery?

Yes (1) No (2)

Answer If Were you required to take any cross-cultural service deli... Yes Is Selected

Q2 If yes, did you learn about service delivery techniques specific to South East Asian clientele?

Yes (1) No (2)

Q3 Please rate how well your program has educated you on psychological service delivery techniques to clients who are specifically of the South East Asian ethnicity/culture.

Not At All (1) Somewhat (2) Fair Amount (3) Very Much (4)

Q10 Why? Please explain:

80

Q4 Please rate how prepared you feel to deliver school psychological services to those who are of the South East Asian ethnicity/culture.

Not At All (1) Somewhat (2) Fair Amount (3) Very Much (4)


Q5 Please rate how important you think learning about different methods and ideas of psychological service delivery are, specifically those of the South East Asian ethnic/cultural perspective.

Not Important (1) Somewhat (2) Fair Amount (3) Very Important (4)


Q16 What is your gender?

Male (1) Female (2)

Q17 In what state are you attending school to receive your degree?

Arizona (1) California (2) Colorado (3) Illinois (4) Iowa (5) Michigan (6) Minnesota (7) South Carolina (8) Texas (9) Wisconsin (10)

Q6 How many years of experience do you currently have as a school psychologist?

Practicum Only (1) 1 year (2) 2 years (3) 3 + years (4)

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Q7 What level of education are you currently working toward?

Masters (1) Ed. S (2) Ph.D (3)

82

Appendix C: Consent to Participate – Grounded Theory Interview

Consent to Participate In UW-Stout Approved Research

Title: Multiculturalism in the Field of School Psychology

Investigator: Carl Romstad, M.S.Ed. 715.308.3460

Research Advisor: Kevin Doll, Ph.D. 121 Home Economics 715.232.2792

Description:

The purpose of this study is to provide information on the possible cultural bias of the discipline of psychology, more specifically, school psychology. Psychology as a whole is considered a social science, or, a set of cultural/ethnic philosophies. The population of those involved in the construction of the foundational roots and concepts of psychology and its many sub-disciplines were, and in many cases still are, people of, or those influenced by, the Euro-American Judeo Christian population. Those considered Euro-American Judeo-Christian are people practicing the culture of European and Euro-Americans as well as the Judeo-Christian spirituality. This study will provide some information on areas of education that are missing for practicioners and students in service delivery methods that will specifically serve the south-east asian population of clients they serve.

Risks and Benefits:

While every situation comes with risks, the risks in this survey will be relatively minimal. Subjects will be asked about their opinions and attitudes towards the education they received pertaining to their practice, how useful this education was to the population they serve, and how their practices would have to be modified with their own personal cultural knowledge to be a successful service provider. Some questions may not be answered simply because the person surveyed refuses or cannot think of a response. Also, this survey may uncover frustration due to the idea that the discipline being spoken of is seen as culturally bias.

Special Populations:

83

The population being interviewed will be those of the South-East Asian ethnicity/culture that provides services to those of the same cultural/ethnic population.

Time Commitment and Payment: It will take up to 30 minutes to complete the survey. There will be no compensation of your time.

Confidentiality:

Your name will not be included on any documents. We do not believe that you can be identified from any of this information. This informed consent will not be kept with any of the other documents completed with this project

Right to Withdraw:

Your participation in this study is entirely voluntary. You may choose not to participate without any adverse consequences to you. Should you choose to participate and later wish to withdraw from the study, you may discontinue your participation at this time without incurring adverse consequences.

IRB Approval:

This study has been reviewed and approved by The University of Wisconsin-Stout's Institutional Review Board (IRB). The IRB has determined that this study meets the ethical obligations required by federal law and University policies. If you have questions or concerns regarding this study please contact the Investigator or Advisor. If you have any questions, concerns, or reports regarding your rights as a research subject, please contact the IRB Administrator

Investigator: Carl Romstad [email protected] 715.308.3460

Advisor: Kevin Doll, Ph.D. [email protected] 715.232.2792

IRB Administrator: Sue Foxwell, Director, Research Services 152 Vocational Rehabilitation Bldg

UW-Stout Menomonie, WI 54751

mailto:[email protected]


84

715-232-2477 [email protected]

Statement of Consent:

By signing this consent form you agree to participate in the project entitled, “Multiculturalism in the Field of School Psychology”

_________________________________________________

Signature Date

__________________________________________________________________________

Signature of parent or guardian (if participant is under the age of 18) Date

85

Appendix D: Consent To Participate - Quantitative Survey Instrument

Consent to Participate In UW-Stout Approved Research

Title: Multiculturalism in the Field of School Psychology

Investigator: Carl Romstad, M.S.Ed. 651-600-5208

Research Advisor: Kevin Doll, Ph.D. 121 Home Economics 715.232.2792

Description:

The purpose of this study is to provide information on the possible cultural bias of the discipline of psychology, more specifically, school psychology. Psychology as a whole is considered a social science, or, a set of cultural/ethnic philosophies. The population of those involved in the construction of the foundational roots and concepts of psychology and its many sub-disciplines were, and in many cases still are, people of, or those influenced by, the Euro-American Judeo Christian population. Those considered Euro-American Judeo-Christian are people practicing the culture of European and Euro-Americans as well as the Judeo-Christian spirituality. This study will provide some information on areas of education that are missing for practicioners and students in service delivery methods that will specifically serve the south-east asian population of clients they serve.

Risks and Benefits:

While every situation comes with risks, the risks in this survey will be relatively minimal. Subjects will be asked about their opinions and attitudes towards the education they received pertaining to their practice, how useful this education was to the population they serve, and how their practices would have to be modified with their own personal cultural knowledge to be a successful service provider. Some questions may not be answered simply because the person surveyed refuses or cannot think of a response. Also, this survey may uncover frustration due to the idea that the discipline being spoken of is seen as culturally bias.

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Special Populations:

The population being interviewed will be individuals in the field of school psychology and currently receiving training to become future school psychologists.

Time Commitment and Payment:

It will take up to 30 minutes to complete the survey. There will be no compensation of your time.

Confidentiality:

Your name will not be included on any documents. We do not believe that you can be identified from any of this information. This informed consent will not be kept with any of the other documents completed with this project

Right to Withdraw:

Your participation in this study is entirely voluntary. You may choose not to participate without any adverse consequences to you. Should you choose to participate and later wish to withdraw from the study, you may discontinue your participation at this time without incurring adverse consequences.

IRB Approval:

This study has been reviewed and approved by The University of Wisconsin-Stout's Institutional Review Board (IRB). The IRB has determined that this study meets the ethical obligations required by federal law and University policies. If you have questions or concerns regarding this study please contact the Investigator or Advisor. If you have any questions, concerns, or reports regarding your rights as a research subject, please contact the IRB Administrator

Investigator: Carl Romstad [email protected] 715.308.3460

Advisor: Kevin Doll, Ph.D. [email protected] 715.232.2792

IRB Administrator: Sue Foxwell, Director, Research Services 152 Vocational Rehabilitation Blg.



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UW-Stout Menomonie, WI 54751 715-232-2477 [email protected]

School Psychological Service Delivery to the South-East ...book, School Psychology for the 21st...

Documents

Transcript of School Psychological Service Delivery to the South-East ...book, School Psychology for the 21st...