CULTURAL DISSONANCE AMONG GENERATIONS: A SOLUTION-FOCUSED APPROACH WITH EAST ASIAN ELDERS AND THEIR FAMILIES

Journal of Marital and Family Therapy, Oct 2004 by Lee, Mo Yee, Mjelde-Mossey, LeeAnn

Collaborating With the Families: An Empowering Process of Change

Solution-focused therapy honors families as knowers of their experience with sufficient resources to define treatment goals and achieve change (Berg & Kelly, 2000). The therapist becomes the family's "community of other" to whom the family redefines their realities. To achieve this collaborative process, solution-oriented family therapists use "evaluative questions" to explore goals and empower the family to take ownership of life choices and decisions (M. Y Lee et al., 2003). Instead of directly providing feedback or suggestions, evaluative questions initiate a self-feedback process in which family members self-evaluate their situations in terms of their doing, thinking, and feeling. The list of "evaluative questions" is potentially endless. They include, but are not limited to, exception questions, scaling questions, coping questions, and relationship questions (DeJong & Berg, 2002), connection questions, choice questions, helpfulness questions, and ownership questions (M. Y Lee et al., 2003). By asking evaluative questions, the worldviews of individual family members are fully respected and incorporated in the process of change as they are the causal agents in constructing and achieving solutions to problems of cultural dissonance. Enduring therapeutic gains are more likely to occur when the family owns the process of treatment and ultimately, the successes.

Despite the importance of convening the message that the family is the "expert" regarding their situation and have answers to their problems, East Asian culture generally emphasizes hierarchy in familial and social relationships. The importance of establishing credibility and expertise of the therapists has repeatedly been discussed in the literature regarding treatment with Chinese (E. Lee, 1996), Japanese (Matsui, 1996), and Korean populations (Kim, 1996). Establishing therapist's expertise and honoring family as "knower" of their situation are not necessarily mutually exclusive. Therapists should not hesitate to provide information on personal credentials, qualities, and educational backgrounds early on in the treatment process (Jung, 1998; E. Lee, 1996). The therapist can share with the family his or her successful work experience with families encountering similar problems. Another helpful way to convey expertise is to provide structure of therapy early on in the treatment process. This is especially important for East Asian families as many of them, especially the elders, may not have previous experience with therapy. Clear introduction of the structure of therapy helps to lessen the potential anxiety regarding seeking therapy and establishes therapist's competence in monitoring the treatment process (M. Y. Lee, 2000) in addition to preparing the family for a solution-focused frame of mind and the questioning style of solution-focused therapy. Although family members take the role of expert in determining and achieving goals that will lead to increase harmony in their family life, the therapist remains the expert in the conversation of change (de Shazer, 1991).