Influence of culture on coping: Rethinking interventions
By Ma Kyung-hee
As a former international student and current mental health professional, I am deeply interested in understanding how culture informs coping strategies in a cross-cultural adjustment context because it provides valuable insight into understanding human behavior that enables sustainable well-being and successful adaptation.
Many cross-cultural psychologists posit that culture provides the context in which stress and coping responses are best understood. Individuals typically appraise stressful experiences through the lens of their cultural framework. Then, they look for internal and/or external resources, culturally embedded, and select coping strategies congruent with their cultural values and practices. This process impacts the effectiveness of the coping strategies that are implemented. This theoretical conceptualization highlights variations denoted in the appraisal, coping, and outcomes across different cultural groups. It requires mental health providers to give greater attention to culturally-attuned services when working with a diverse population.
Considering the rate of academic globalization, mental health practitioners (particularly those in school settings) must understand the intricate connection between culture and coping mechanisms. Gaining this understanding would enable the practitioners to move away from an ethnocentric cultural perspective and facilitate deliberate and continuous efforts to explore clients' cultural identities with empathic listening and cultural humility. In the absence of cultural awareness, mental health practitioners can inadvertently pathologize the client's problems and offer a quick fix that oversimplifies a situation.
As a case in point, during my first-year internship at a public school in the U.S., I was assigned to a case involving a 10-year-old Asian American student who was coping with the loss of his father. He went through a year-long bereavement manifested at first by intense crying in public, followed by complete silence. In his culture, people honor the dead through silence; silence has meaning. However, unfamiliar with his cultural belief regarding death and grief, the personnel at his school misconstrued this change in his behavior as a form of repressed, delayed grief of which he was in denial. The school personnel perceived him as “weak and emotionally behind” and needing further counseling. My client insisted that he was fine, but the school personnel remained firm in their belief. He felt frustrated and helpless.
My client's feelings of frustration and helplessness stemmed from the school personnel's failure to understand and accept that his coping strategies were culturally appropriate. Expressions of grief and bereavement are culturally constructed and take many different forms. Human beings are conditioned to cope with stressful situations in customary ways permitted by their own cultural values and norms, as my client did.
For example, Asian culture tends to endorse emotion-focused coping strategies, such as emotional regulations, acceptance, and positive reframing, whereas Western culture prefers problem-focused coping that encourages concerned individuals to talk about their problems and actively seek solutions. Without this understanding, practitioners may wrongly assume there is a right way to process grief and a universal time frame applicable to all individuals.
My awareness of Asian culture informed me that the client's silence was indicative of triumph and strength, not of weakness, and signified that he had begun to recover. Guided by this cultural understanding, I redesigned interventions in collaboration with the client, this time focusing more on raising cultural awareness in schools.
The new interventions included activities, such as educating students and faculty during class or staff meetings, and advocating for the client when needed. The overarching goal was to help school personnel understand that people develop their own coping repertoire within the framework of their culture and that aligning with one's cultural norms promotes healing, as my client experienced.
Individual-level interventions were devoted to recognizing personal and environmental protective factors and developing new meanings in the client's life. For example, we sought opportunities to use his experiences to help students who were facing similar losses in their lives. Additionally, we explored different cultural orientations on coping styles and discussed the importance of self-advocacy especially when cultural conflicts occurred. Although my client and I did not observe notable changes in the school setting in part due to disinterest and resistance among school personnel and a limited time frame, we both agreed that the seeds planted would eventually benefit future students.
In every sense, our cultural experience determines how we respond to the world around us. Cultural values and norms may be malleable for those who have frequent cross-cultural exchanges, but represent the collective consensus of what is acceptable in matters of stress and coping. In dealing with diverse populations, mental health practitioners must give explicit attention to clients' cultural frames of reference. Making culture-specific inquiries and honoring clients' unique experiences will enable the practitioners to get to the heart of the client's problem and facilitate full recovery leading to optimal development.
Ma Kyung-hee (kyungheem@daum.net) is an editor and researcher specializing in mental health.