Novice Counselor's blog

According to David & Okazaki, (2006), colonial mentality is a construct that is central to the understanding of the psychology of contemporary Filipino Americans. Recent health statistics show that Filipino American adolescents have one of the highest rates of suicide ideations and attempts in the country (President’s Advisory Commission on Asian Americans and Pacific Islanders, 2001) and Filipino Americans have depression rates that are significantly higher than the rates of the U.S. General population. The therapist working with Filipino Americans is advised to take into consideration the cultural factors on the psychological experiences of Filipino Americans. Psychologists need to view Filipino American culture through the context of Spanish and American colonization. The influence of the colonial past is thought to continue on modern-day Filipinos and Filipino American culture. In particular, scholars from various disciplines have asserted that CM continues to exist among modernday Filipino Americans and that it continues to influence the psychological experiences of these individuals (David & Okazaki, 2006).

Filipinos and Filipino Americans have experienced both classical colonialism and internal colonialism here in the United States as well as in the Philippines. Studies have asserted that the history of colonization and its accompanying cultural replacements have contributed to the ever-present Filipino ethnic and cultural identity crisis—confusion as to what constitutes an authentic Filipino culture and Such an identity crisis is believed to lead toward the conclusion that there is no authentic Filipino culture and identity that one can be proud of, and thus, may lead to the perception of inferiority toward anything Filipino. There are four different ways in which CM is thought to be manifested in Filipino American individuals:
(a) denigration of the Filipino self,
(b) denigration of Filipino culture and
body,
(c) discrimination against less Americanized Filipino Americans, and (d) tolerance and acceptance of historical and contemporary oppression of Filipinos and Filipino Americans (David & Okazaki, 2006).

Psychologists and other mental health service providers working with Filipino Americans should become familiar with this population group’s colonial past and the notion of CM. Furthermore, it is important to note that CM should be viewed as an individual differences variable, so as to avoid assuming that every Filipino American individual holds CM and experiences poor self-regard (David & Okazaki, 2006).

During the initial interview with the Filipino immigrant, the REBT counselor should assess the extent to which CM plays in the client’s emotional world. The counselor would help the client describe his problem while using active listening skills and conveying genuine interest in the client. The counselor should focus the interview by asking pertinent questions and come to an agreement about goals for the session while assessing emotional and behavioral consequences. The counselor should identify the activating event, if any, for the client’s depression. Subsequently, the REBT counselor would help the client identify any irrational beliefs and how they connect to his feelings and behaviors. The REBT counselor would utilize a combination of logical, empirical and functional disputes to help the client replace his irrational beliefs with rational alternatives. (Capuzzi & Gross, 2007).

The disabled client in a wheelchair has lost a function or a body part, and this loss must be dealt with as an adjustment to disability. The case does not mention how recently the loss occurred. Perhaps the client never dealt successfully with this loss and this could be a reason for her current difficulties. Or perhaps there are some recent events in the clients life that triggered her distress.

Disabled patients must come to grips with the fact that although life will continue, it will probably continue in a way that is different from that experienced prior to the disabling illness or injury. How one deals with such a loss is central to the psychology of disability. Before dealing with adaptation to disability, it is important to consider that physical or functional loss is a relative phenomenon. The importance of what a person has lost is only meaningful within the total context of that particular individual’s life (Grzesiak, 1979).

In their attempts at dealing with the loss of a significant body part or body function, one expects denial, anger, anxiety, depression, and sometimes apathy to be transient affects and behaviors.

Because the personal aide may have more intensive, often daily, contact with the patient, she may offer information about the patient’s performance and attitudes. The therapist would do well in interviewing the personal aid.

Studies have observed that there are three general categories of psychological problems that require psychotherapeutic assistance. The categories are as follows: psychological problems that existed-prior to the disability and continue to be present, psychological problems that existed prior to the disability that have been exacerbated by it, and psychological problems that are a direct result of or reaction to disability (Grzesiak, 1979).

A spectrum of psychological states are subsumed under the reaction-to-disability category; the more frequent states include the following: anxiety, depression, anger, loss of self-esteem, lack of self-worth, identity confusion, sexual preoccupation, fear of death, suicidal rumination, isolation and withdrawal, denial of disability, and oppositionism.
Many psychotherapists balk at the thought of providing psychotherapy for the physically disabled.
They may ask, How can I help this person to accept his disability when I think I would kill myself if it were me? (Grzesiak, 1979)

In the initial interview with the disabled client the REBT therapist would attempt to identify any unresolved issues in dealing with the disability. Additionally, the REBT therapist would use the same approach to treat the disabled client as any other client by helping her tell her story while using active listening skills and conveying genuine interest in her.
The counselor and client would then come come to an agreement about goals for the treatment. The counselor would identify the activating event, if any, for the client’s difficulties. Subsequently, the REBT counselor would help the client identify any irrational beliefs and how they connect to her feelings and behaviors. As with any other client, the REBT counselor would utilize a combination of logical, empirical and functional disputes to help the client replace his irrational beliefs with rational alternatives. (Capuzzi & Gross, 2007).

References:

Capuzzi, D., Gross, R.,(2007); Counseling and Psychotherapy Theories and Interventions; 4th Edition, Pearson Education, Inc.

David, E. J. R., Okazaki, S., (2006) Colonial Mentality: A Review and Recommendation for Filipino American Psychology; Journal of Cultural Diversity and Ethnic Minority Psychology, Vol. 12, No. 1, 1–16

Grzesiak, R. C., (1979); Psychological Services in Rehabilitation Medicine: Clinical Aspects of Rehabilitation Psychology; Journal of Professional Psychology 511