As we move into Asian American Pacific Islander (AAPI) month this year, I wanted to focus on the need for more inclusive therapeutic support for AAPI individuals. I have heard many times both in my personal and professional life, from AAPI identifying people that have had experience with therapy before that it seemed like their non-Asian therapist had a difficult time understanding their issues, story, and most importantly them.

For those instances in my professional life, this has led many AAPI individuals and couples alike to seek out therapists who also identify as AAPI as they can better understand the nuance of their presenting issues and the complexity of other topics such as culture and family dynamics. In my personal life, these stories have led me to feel a mixture of emotions, from fluster to shock, and from dismay to curiosity to name a few. What I noticed here is that both my professional and personal stances are in both shock and understanding of how difficult it can be sometimes for therapists to understand some of the nuances that come with AAPIs sharing their complex stories.

The main thought that I also hear is that often, there is not enough understanding about the AAPI identity. Part of the reason being that culturally, many Asian communities are just beginning to explore the usefulness and vulnerability of seeking therapy support.

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Understanding the Barriers AAPI Individuals Face in Therapy 

In years past, AAPI people seeking help for mental health has typically been seen as a taboo. The Asian view is that we are to figure issues out ourselves as seeking help in general can be seen as a failure in many family dynamics. A lack of knowledge regarding mental health is also prevalent in therapeutic spaces not being accessed by the AAPI community. This combined with a strong cultural view of shame can keep many AAPI people tethered to cultural perspectives, leading to a less than easier route to sound health.

Even when AAPI clients do get into therapy, the underlying issue of misunderstanding can continue to impact the progress that can be made. Such that issues like interpersonal relationship dynamics and family dynamics can be shared in the therapy space but can be misinterpreted as neglect, abuse, or dysfunctional. What happens then is a prolonging of the pain, hurt, shame, and guilt that has impacted their lives for so long. The lack of knowledge about mental health from an Asian cultural perspective taken into consideration, it is understandable that there is still a gap that can be bridged for AAPIs seeking therapy and the therapists who wish to work with them.

There is additionally a large barrier in finding a trained professional such that there is a reported lack of AAPI providers. According to the American Psychological Association in 2018, a 2015 survey from the US Census Bureau found that 86% of psychologists in the US identified as White, with 5% being Asian. So, although there is a demand for AAPI therapists, the supply is low.

Looking back to what I have mentioned above, those who have sought therapy services and identify as AAPI have mentioned to me that it has been difficult finding a professional who can adequately understand their circumstances, let alone someone who is also AAPI. With the data in mind, it can be difficult from a prospective client’s perspective to seek out the support they want when it is already hard to find someone who can be relatable.

Creating Inclusive and Culturally Sensitive Therapeutic Spaces

This is not to say that non-Asian therapists cannot work with AAPI clients. I think any therapist of any race and culture can do phenomenal work and build an amazing therapeutic rapport with careful consideration, proper training, and appropriate cultural sensitivity. Of course, Sage has many therapists that can adequately work with the AAPI population; and even have therapists that are AAPI-identifying themselves.

For those who identify as AAPI who have either wanted to seek therapy or are actively in it and are reading this, I ask you to consider some of the questions you may have asked yourself:

• “How can I talk about my emotions with my family when my culture is typically nonverbal and motivated by acts of service?”
• “How do I let my parents know I would like to prioritize my mental health? And what if they downplay it or passively mock it?”
• “What if setting boundaries with my family feels like I have cut ties with my home, and by extension my culture?”
• “How can I even translate what I’ve learned about myself to a language that might find it difficult culturally to understand such things?”
• “How can I blend my home culture together with the Western culture (and many other cultures) that I have grown up with?”

These questions can challenge us in how we can nurture our mental health while also celebrating our roots. Just as important, they are valid in a therapeutic space and can be further explored in depth over time.

As someone who has worked with many in the AAPI community and continues to advocate for support within the community, I believe that there is a therapeutic space for all who identify as AAPI with all its diversity. Regardless of whether one is multiracial, white passing, South Asian, East Asian, 1^st, 2^nd, or 3^rd generation, I encourage you to share your experiences with the therapist that is a sensitive, considerate fit for you.

Your therapist will work with you to advocate for you, making space for all areas of your racial, cultural, and ethnic identity. I would also encourage you to consider how you want to bring your full AAPI identity into your own therapy space; a space without judgment, just a desire to learn and understand.

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Conclusion 

In closing, the AAPI community can benefit from therapy and therapists that can consider their experiences from their viewpoints. Many who have initially tried therapy have found it helpful but left feeling unheard because there can be so many complexities related to the community, culture, and values. People who have found a space that is warm, culturally sensitive, and actively taking time to listen and consider have found the experience fruitful. In both my personal and professional life, I have seen and heard such stories and have felt a strong sense of warmth and humility in being able to hold space for a community that is beginning to embrace therapy and help-seeking. Although work still needs to be done to destigmatize and redefine what therapy is in the AAPI community, my experience has shown that we are making strides.

Prioritizing your mental health and needs is a courageous step in the AAPI community. Cultural understanding is crucial in the therapeutic relationship. After all, part of therapy is being able to come as you are without fear of not being understood or heard for who you are.

Additional Reading & References:

• Demystifying Psychotherapy: A Chinese-American Therapist’s Perspective‍
• Lin, L. (2018, February). How diverse is the psychology workforce? News from APA’s Center for Workforce Studies. American psychological association.