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

USING A SOLUTION-FOCUSED APPROACH TO ADDRESS CULTURAL DISSONANCE

Solution-focused brief therapy was originally developed at the Brief Family Therapy Center in Milwaukee by Steve de Shazer, Insoo Kim Berg, and their associates (Berg, 1994; de Shazer, 1991; DeJong & Berg, 2002). It begins as atheoretical with a focus on determining "what works in therapy." The evolved practice techniques and their basic premises, however, are consistent with the concepts of multiple worldviews, empowerment, and a strengths perspective-ingredients that are conducive to a responsive and respectful practice approach in a cross-cultural context. The focus on pragmatic changes and holding clients accountable for solutions also complements the characteristics of help-seeking behaviors of East Asian families.

A Constructivist View of Problems and Solutions: Respecting Multiple Worldviews

Influenced by social constructivism, solution-focused therapists do not assume an a priori expertise sufficient to objectively categorize and solve families' problems (Berg & DeJong, 1996). The therapist would first seek to understand each family member's view of the problems and solutions and incorporate their multiple worldviews in the treatment process prior to assisting them to define goals for treatment (Berg, 1994). Solution-focused therapists oftentimes use the miracle question (Berg & Miller, 1992) to assist the family to envision a future with family harmony and acceptance and to establish explicit and clear indicators of change so that they know when the healing begins. Some East Asian families, however, may not feel comfortable with the idea and/or the language of a miracle. When the first author, who is originally from Hong Kong, conducted solution-focused brief therapy workshops with Chinese-speaking therapists in Hong Kong, participants shared with the author that miracle question is strange and foreign to most clients and families in Hong Kong. Culturally sensitive solution-focused therapists can use future-oriented outcome questions for achieving the same therapeutic purpose: "If I see your family three months from now and you are better able to deal with your differences, how will I know that your family is different? "How would the relationship between grandmother and the children be different?" "If your ancestor listened to your prayer, how would your family be different than what it is now?" The therapist can utilize cultural beliefs and practices in phrasing the outcome questions as a way to elicit individual family members' views of solutions regarding what is viable and helpful for them in their unique sociocultural milieu (M. Y. Lee, 1997).

Because different worldviews usually exist in a family troubled by the problem of cultural dissonance, a major clinical challenge is to create a therapeutic context in which values of individual family members are recognized and negotiated while the intergenerational hierarchy is respected at the same time. Although it is imperative to elicit, respect and incorporate multiple worldviews in the treatment process, E. Lee ( 1996) suggests that it is important to identify the decision makers in the family and gain their support. Culturally sensitive solution-focused therapists would first join with the existing hierarchy of the family. Usually, this might mean joining with and inviting the oldest male member in the family to speak first (Ho, 1993; Jung, 1998). Because East Asian elders should be respected, and they are usually more reserved in expressing themselves, the therapist should respectfully invite them to participate in the treatment process and compliment their contributions whenever appropriate. For instance, "Mrs. Song, you are an important member in this family, and I would like to hear from you your ideas about what maybe helpful to create harmony in this family."