Article

Working With Asian American Youth at Clinical High Risk for Psychosis A Case Illustration

‡Boston University, Boston, MA
The Journal of nervous and mental disease (Impact Factor: 1.69). 05/2013; 201(6). DOI: 10.1097/NMD.0b013e3182948084
Source: PubMed

ABSTRACT

The idea of a clinical high risk (CHR) for psychosis has focused attention on early intervention to prevent or attenuate psychosis. However, many clinicians may still not be very familiar with the concept of CHR. Current studies have not allowed for an in-depth examination of the challenges and the strategies of working with youth from the range of racial/ethnic minority families, Asian American families in particular. The purpose of this article was three-fold. First, we critically review Asian cultural values and beliefs about mental illness, psychosis in particular, while highlighting specific challenges that Asian American families encounter. Second, we provide a clinical case to illustrate these challenges and inform clinical practice when working with Asian youth at risk for psychosis and their families. Third, practical and easy-to-follow clinical strategies are provided. Implications for clinical practice and directions for future research are presented.

Download full-text

Full-text

Available from: Michelle S Friedman-Yakoobian, Oct 01, 2014
  • [Show abstract] [Hide abstract]
    ABSTRACT: Mental disorders often emerge for the first time in adolescence. When mental disorders are recognized and treated early, the chances of better long-term outcomes are increased. Nonetheless, professional help is often not sought or sought only after a delay or under emergent circumstances, thus leaving the mental health needs of our youth largely unmet. The likelihood is that early recognition and appropriate help-seeking for troubled youth will be increased when youth and their caregivers, such as parents, are aware of the importance of mental health and its related issues. Knowledge about various types of mental disorders, including the ability to recognize specific disorders, knowledge of risk factors and causes, an understanding of possible early cognitive and behavioral indicators, as well as information about available help and access to it, enhances awareness and promotes mental health. A person with such knowledge has been described as mental health literate, a connotation similar to that used in the literature examining the relationship of general health knowledge to various factors affecting physical health. In this book chapter we address mental health literacy and its impact on youth mental health and strategies to promote mental health literacy at individual, community, and government levels.
    No preview · Article · Jan 2013
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Research focused on the prodromal period prior to the onset of psychosis is essential for the further development of strategies for early detection, early intervention, and disease pre-emption. Such efforts necessarily require the enrollment of individuals who are at risk of psychosis but have not yet developed a psychotic illness into research and treatment protocols. This work is becoming increasingly internationalized, which warrants special consideration of cultural differences in conceptualization of mental illness and international differences in health care practices and rights regarding research participation. The process of identifying and requesting informed consent from individuals at elevated risk for psychosis requires thoughtful communication about illness risk and often involves the participation of family members. Empirical studies of risk reasoning and decisional capacity in young people and individuals with psychosis suggest that most individuals who are at-risk for psychosis can adequately provide informed consent; however ongoing improvements to tools and procedures are important to ensure that this work proceeds with maximal consideration of relevant ethical issues. This review provides a discussion of these issues in the context of international research efforts.
    Full-text · Article · Nov 2014 · Philosophy Ethics and Humanities in Medicine
  • [Show abstract] [Hide abstract]
    ABSTRACT: This chapter presents the voices from a high-achieving and highly stressed group of Chinese American/immigrant adolescents (C-A/IAs). We chose this group for the study because their strong grade point averages and standardized test scores could obscure their high risks for distress, consequently their psychological needs and struggles are often neglected. Through focus groups, ecomaps, and interviews, 33 C-A/IAs of two age groups, 10–12 and 15–17, 11 boys and 22 girls, shared their experiences of daily struggles to meet multiple demands, coordinate conflicting expectations as well as a longing for understanding from parents, teachers, and others. We used the uniformed method of coding and analysis of data described in Chap. 2 to analyze the verbatim transcripts from the focus groups and interviews and ecomap drawings. Across age and gender, a loud and clear voice came out from many responses: Reduce stress and return to a balanced life. C-A/IAs told us about their sources of stress and support as well as their coping strategies and how they would help each other. They also depicted ambivalent relationships (source of both support and stress) in their home and school environment through their ecomaps. In addition, C-A/IAs provided comprehensive and practical suggestions to parents, teachers, school counselors/psychologists, and schools/communities on how interventions could be tailored to this population. These suggestions should inform teachers, parents, school counselors, school psychologists, and other professionals in developing a culturally responsive promotion of mental health for C-A/IAs and other culturally diverse students.
    No preview · Chapter · Jan 2016