Culture Counts: Designing Relevant Interventions and Responsible Gaming Strategies for Asians and Asian-Americans

Dr. Nolan Zane, professor of psychology and Asian-American studies at the University of California, Davis, kicked off the session with a discussion about the importance of cultural competency when establishing treatment plans. He outlined three types of cultural competency: cognitive competency, which includes academic knowledge; affective competency, which is the ability to understand unique difficulties that different cultural groups may experience; and role competence, which is a basic understanding of the way roles and behavior influence relationships in a culture. Role competence, he said, is the most difficult to learn.

Zane focused his presentation on cultural values in Asian communities and how they can affect the client-therapist relationship. The first issue he examined was face, which is defined as a person’s set of socially-sanctioned claims concerning his/her social character and integrity. Zane’s research has shown that face can affect self-disclosure among problem gamblers. During treatment, people concerned about face will exhibit certain behaviors, such as careful monitoring of conversations, self-restraint in expression or the use of respect, politeness and courtesy as protective maneuvers. In these situations, a clinician must provide a patient with avenues to save face.

Also, Zane found that East Asian cultures socialize people to handle emotions differently. Western cultures view emotional suppression as negative, but Eastern cultures view emotional suppression more positively. Therefore, since psychotherapy is often centered on catharsis, this approach may be in direct conflict with what Eastern cultures teach.

Chien-Chi Huang, Asian community program specialist for the Massachusetts Council on Compulsive Gambling, discussed the translation of the gambling self-help tool Your First Step to Change into three Asian languages (Mandarin, Khmer and Vietnamese) and the challenges inherent in developing problem gambling resources targeted at Asian communities.

During the translation process, researchers took care to ensure that the tone was gentile and nonjudgmental. During the adaptation process, researchers added new information about family involvement and problem gambling prevalence. Design of the booklets also was important, as each version used a design that was most meaningful to each community’s culture. A natural motif was used in all three to convey health and healing.

During the question and answer portion of the session, the panel was asked how clinicians encourage members of Asian communities to see a value in treatment. Zane said that treatment rates in Asian communities are low and recommended developing ways to help those who need it without having to actually see them face-to-face. Huang added that many Asians see gambling problems as a moral issue. She said that treatment providers should respond by telling problem gamblers that it is a serious health issue that should be addressed.