The use of culturally-based variables in assessment: Studies on loss of face.

Invariably, clinicians find themselves in the predicament of prescribing what constitutes appropriate assessment for Asian American clients. On the one hand, many culturally sensitive and culturally competent clinicians think and go about doing assessment in certain ways to account for and incorporate the cultural background and experiences of Asian American clients into the diagnostic, case conceptualization, and treatment planning processes. Sometimes certain procedural and stylistic changes are indicated while at other times completely different assessment strategies and approaches are necessary to achieve effective outcomes. We also know with a fair degree of confidence that such changes in the traditional Western therapy regimen have an ameliorative effect, which result in clinically significant improvements in treatment efficacy. On the other hand, when asked to describe the manner by which these clinicians come to select a particular strategy or to implement a certain procedure, we frequently experience difficulty in articulating this process. This difficulty cannot be solely attributed to language problems. American-born, primarily English-speaking Asian American therapists also may find it difficult to explain the process by which they account for and use cultural information to enhance interventions. Rather, the problem results more from the use of a Western-based “therapeutic language” that prevents us from expressing the cultural dynamics involved in a particular case.