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Fam Proc 23:365-374, 1984

Structural Family Therapy

Its Application to Chinese Families
Marshall Jung, D.S.W.a
aFamily Service Association of Riverside, 3903 Brockton Avenue, Riverside, California 92501.

Research studies show that Chinese communities in the United States are in need of mental health services. Structural
family therapy offers an effective model for treating families in need of therapy. This article describes why and how the
model can be applied.
In the late 1960s, with the advent of the Asian-American movement, the problems of the Chinese1 in America were
brought to the forefront. Prior to that time, the problems facing the Chinese were believed to be solvable by the Chinese
themselves (13). Through the cooperative efforts of many community-based Asian-American groups throughout the United
States, closer examination of the needs of Chinese in America has begun. Since the late sixties, numerous studies have
addressed the areas of social service, health (including mental health), housing, employment, and educational needs of
Chinese-Americans.
The 1980 Census indicates that there are 806,027 Chinese, mostly foreign born, residing in the United States, 65 per
cent of whom live in three states: California with 322,340, or 40 per cent; New York with 148,104, or 18 per cent; and
Hawaii with 56,260, or 7 per cent. The majority of Chinese, 412,727, or 51 per cent also reside in four major urban
centers: San Francisco-Oakland with 142,570, or 18 per cent; New York with 124,764, or 15 per cent; Los Angeles-Long
Beach with 93,747, or 12 per cent; and Honolulu with 51,646, or 6 per cent.
Although the extent to which mental health problems exist among the Chinese in America has never been fully
documented or understood, there is both circumstantial and direct evidence that they are in need of mental health services.
Many of the mental health problems are associated with the conditions in which a variety of Chinese live, particularly those
in Chinatowns. In Chinatowns, the social problems of overcrowded living conditions, which include gang violence and
criminal behavior, poor health, illegal immigration, and a high incidence of suicide and unemployment coupled with
economic exploitation of recent immigrants, is well documented (2, 3, 6, 11, 12). Many Chinese are also faced with the
burdens of discrimination and the loss of cultural identity on the part of their second and third generations. The above
problems, compounded by the circumstance of immigrants living in a foreign society in which cultural values are
antithetical to their native country, tend to create tremendous stress on individuals and their families. Unless these
individuals possess unique coping skills, the stress for many will lead to depression, despair, disorientation, and
dysfunctional family patterns. Research indicates that Chinese underutilize mental health services and when seeking such
services they come with more severe disturbances than other segments of society (1, 8, 11).
In an effort to meet effectively the needs of Chinese seeking individual or family therapy, researchers are examining what
clinical approach might best be suited to this population. A recent study of a national sample of 345
Pacific/Asian-American mental health practitioners, for example, indicated that Pacific/Asian therapists prefer the use of
the cognitive behavior modality over the phenomenological psychodynamic and pharmacotherapy modalities (9).
The use of structural family therapy as a treatment model for Chinese individuals seeking therapy from a family or mental
health agency will be addressed in this article. It is uniquely suitable for this population because by definition it is a family
approach with broad applicability to various socioeconomic groups and presenting problems and with an emphasis on the
social context in which families live, on appropriate generational boundaries, on the joining process, on problem-solving,
on focusing on strengths, and on the therapist as an authority figure and change agent.

Social Context of Chinese in America

The special problems associated with trying to provide mental health services to the Chinese in the United States are
similar to those of many other hard-to-reach minority groups. At present there are insufficient bilingual and bicultural
mental health professionals concentrated in strategic locations to serve those who speak primarily Chinese. Adding to this
problem is the erroneous belief that the Chinese are one homogeneous group. Although the majority of Chinese immigrants
are from the district of Toisan in China, plus three or four adjoining districts, many come from other areas of China and
different parts of the world. As a result, there are many cultural differences within the Chinese community. This is
compounded by the many Chinese dialects spoken within the community itself. Further complicating already existing
stresses, the life style of the Chinese is associated with the class in which that person was born and raised. The mental
health professional cannot be knowledgeable about all the cultural and class differences existing within the Chinese
community. Nevertheless, the therapist should be sensitive to the fact that such differences do exist and if faced with
inexplicable resistance ask family members if he or she is violating any cultural or class norms or seek consultation from a
specialist familiar with Chinese culture.

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Structural family therapy is an open systems model that examines the individual in relation to his family and his
environment. The social context in which the family lives is continuously taken into consideration in the therapeutic
process, since the family's social context strongly influences the organizing of its behavior. Consequently, the therapist will
be keenly aware of the social, cultural, economic, and environmental factors, as well as family dynamics, that have led the
family to seek assistance. When necessary, the therapist will elicit or assist families in obtaining essential outside support,
such as day care, employment, immigration, educational, and other services. Help or direction in obtaining support services
is not separated from family therapy but is instead an integral part of it. For example, in many instances, it is much more
helpful to obtain day care services for an overburdened mother of five children than it is to assist her husband to
"understand his wife's feelings." Obtaining support services is essential to working with low-income, traditional Chinese
families.
The structural model can be utilized for working with the diverse socioeconomic groups within the Chinese community
because it has already demonstrated its adaptability and usefulness to many classes of other racial and ethnic groups. To be
useful to various other groups, structural family therapists have had to be flexible, perceptive, and sensitive to the class and
cultural norms of those groups. It is important to stress that they have had to work within those norms without imposing
their own values on them.
In attempting to develop and provide therapy to Chinese, professionals must address themselves to the issue of
acculturation of the Chinese into American society. Acculturation is the change of one group's cultural patterns to those of
the host group. The degree to which any minority group has been acculturated into American society can never be answered
accurately or satisfactorily because the variables by which acculturation is assessed are so complex and because members
within any group are at various degrees of acculturation. Acculturation is predicated on both the desire and the degree to
which an individual wants to be part of the host society and the degree to which the host society will permit him to
assimilate (4).
Acculturation is neither a virtue nor a weakness but a natural process through which groups integrate or fail to integrate
into the host society. In certain instances, however, if some acculturation does not occur, a family's interactional pattern may
become dysfunctional. How this can happen will be discussed later. A great many individuals who live in an atmosphere in
which Chinese values are reinforced, particularly those residing in a Chinatown, are not prone to make changes in this area.
It is with this group that the recognition of cultural differences has the most significance in providing therapy to
dysfunctional Chinese families.
It is difficult to provide effective therapy to Chinese families if the therapist does not have some understanding of the
differences between Chinese and American cultural values. There have been many scholarly writings, such as Hsu's
American and Chinese: Reflections on Two Cultures and Their People (5), which attempt to explain these differences. Far
too often, however, analysis has been based on rhetoric, simple generalities, and personal experiences that do not
necessarily lead to valid conclusions. For example, simply to state that within the Chinese society the elderly are honored
and taken care of, that children are taught to respect their elders, and that there is a strong belief in family unity, has no
relevance without a critical analysis of how these norms interrelate and support the different institutions we collectively call
society. Stating these norms, without substance, would be comparable to stating that "in America, everyone has an equal
opportunity to life, liberty, and the pursuit of happiness." It is imperative that the way the cultural values are manifested and
developed within the total context of the society be considered and understood. Cultural values are interrelated within
society's political, economic, legal, social, and religious systems. Although we attach morality to cultural values, many of
these values are neither right nor wrong but are functional and dysfunctional within an individual or family's social context.
Universally speaking, all societies struggle with similar issues or questions? the questions of why people exist; how society
should be governed; the role of family members; how to provide food, clothing, shelter; how to provide individuals with a
sense of psychological security, identity and purpose; and how to deal with deviance. How these issues are resolved are
demonstrated differently within each society.
The assumption must be made that the coping mechanism of a traditional Chinese family that seeks or is requested to
obtain family therapy are partially dysfunctional and therefore must be modified in order to resolve conflicts. A traditional
Chinese family is one in which Chinese values have been strongly internalized because of life experiences. In such families,
normally both marital partners are foreign-born Chinese, the language spoken by the adults is primarily Chinese, and the
adult's social, cultural and physical needs are met primarily within the Chinese community. New rules for governing
interactions must be developed and incorporated into the family system gradually, bringing about some degree of
acculturation into the American society. The immigrant brings with him rules and values governing behaviors that become
dysfunctional in America because there is no longer the total interconnecting social, economic, cultural, and political
systems to support them. This does not imply that traditional Chinese must make radical changes in their belief system. It
does imply, however, that subtle changes must be made to accommodate the experiences of the family in their native
country and their experiences in America.
In America, individual growth, development, achievement, and maturity are cultural values. Emphasis is placed on
assisting children to become physically and psychologically separated from their parents. Children are expected to be

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competitive, assertive, independent, and individualistic. They generally go through what is commonly referred to as an
"identity crisis" that further helps remove them from their parents.
Child-rearing practices in Chinese culture are not based on the notion of assisting the child to separate but rather on
staying with, and maintaining, strong family ties with ancestors, current family members, and future generations. Although
women leave their family of origin, they are incorporated within, and become a part of, their spouse's family. Chinese
families do not have the stressful responsibility of negotiating marital relationships because marital and family interactional
patterns are dictated by tradition. Traditions are based upon, and intertwined with, the various social, legal, religious, and
other systems within the culture.
Tradition is helpful in reducing certain stresses related to interpersonal conflict, but it is by no means a panacea for
handling all stress. Many individuals have the erroneous stereotype of the Chinese as humble, quiet, polite, and always in
control. Chinese have feelings of anger, insecurity, jealousy, and the entire range of feelings common to all people in
response to their experiences. Lamson (7), in writing about families in China, states:

The adjustment of differing personalities in any home, even though it be a small family of only three or four persons,
is not a simple task because each individual has his or her own likes and dislikes, prejudices and passions, which
may conflict with those of others. When we have the situation which we find in many families in China, of fifteen,
twenty-five, fifty and more persons living together the opportunities for jealousies, favoritism, and constant striving
one against another are very great. Old persons frequently are too indulgent of their favorite grandchildren, petty
quarrels spring up between the various branches of the family, between the old and the young, between wife and
concubine. Constant gossiping, scheming, getting in each other's way, and the thousand opportunities of
maladjustment that come when humans live close together under one roof, all tend to keep the home in an unsettled
and uncomfortable atmosphere. [p. 500]

As indicated earlier, Chinese immigrants, like all immigrants, must learn to make adjustments to survive in their
new-country. If the immigrant family is able to, for the most part, reconstitute its life style in America, with various
economic, family, and institutional support systems within the Chinese subculture, accommodation should go fairly
smoothly. If, however, marital or family conflict should arise (for whatever reason), it will be extremely difficult to assist
that family in resolving its problems. One of the major difficulties is that Chinese families are not psychologically oriented
to the Western culture; these families are unable to comprehend their problems in Western terms and therefore cannot
comprehend or utilize Western coping mechanisms in order to resolve the problems. The following case will illustrate this
point:

John, a 15-year-old Chinese adolescent, was referred to the agency because of school and behavioral problems at
home. He was warm, sensitive, intelligent, articulate, and in some respects, a mature individual. It was apparent that
part of his problem was associated with his desire to be like his American friends. His parents had immigrated to
this country from Hong Kong when he was 10. Having been raised in a traditional environment, his parents did not
attempt to resolve their son's problems, as Americans might, by talking with their son about his mixed feelings.
They did not let him articulate his feelings but instead told him to change. They told him what he should feel but did
not share with him their nurturing and sensitive feelings. They insisted he was shaming the family and should give
absolute obedience to them. The consequences of his disobedience would be disownment and removal from the
family.

The parents in this case were neither right nor wrong. The manner in which they attempted to control their son's behavior
was not functional for Western society. How the case was handled will be addressed later in the article.
Lacking knowledge of cultural differences will mislead many therapists incorrectly to diagnose what is basically a
cultural difference as something that is pathological. For example, if the parents mentioned above were an American family,
their characteristics would be assessed as extremely insensitive, rigid, punitive, and unresponsive, perhaps due to
unresolved conflict within the family of origin.

Family Approach
To serve traditional Chinese in individual therapy is, in some respects, contrary to Chinese cultural values. Individual
growth and development are not within the accepted norm of the Chinese culture, for the individual is always responsible to
the family, whether in the past, present, or future. Yang (14) writes:

A Chinese family, especially in rural China, is far more than a group of related individuals. In Taitou ..., it is a
complex organization of family members, family property, domestic animals, family reputations, family traditions,
and family gods. It can be said that the family extends to the as yet unborn generations and to the long deceased

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ones. The living traditionally believe that their ancestor's spirits, whether in the ancestral graves or in Heaven, are
with them and are keeping watchful eyes upon them at all times.

Since Chinese cannot perceive the individual aside from his family, it is the family, not the individual, that must be
involved in therapy. In many instances, if the family is not involved in the process of bringing about changes within an
individual, the therapy will only exacerbate the problem by further alienating the individual from the other family members.
It is also assumed by structural family therapists that the family system is more powerful than the individual and for that
reason the family must be involved in the therapeutic process.
American families function by negotiating the expression of feelings and ideas, in contrast to traditional Chinese families
in which rules and regulations are dictated by tradition. There is an erroneous belief held by many mental health
professionals that traditional Chinese can neither recognize their feelings nor express those feelings to family members or to
others. That simply is not true. However, traditional Chinese are not accustomed to expressing their emotions overtly; but
they certainly can learn.

Maintaining Generational Boundaries

Structural family therapy provides a conceptual framework that closely aligns itself with the manner in which the
traditional Chinese family is constituted. The Chinese family is highly structured with clearly defined generational
boundaries and roles for everyone. By definition, structural family therapy centers on examining a family's structure, which
is defined as

the invisible set of functional demands that organize the ways in which family members interact. A family is a
system that operates through transactional patterns. Repeated transactions establish patterns of how, when, and to
whom to relate, and these patterns underpin the system. [10, p. 51]

All families can be broken down into subgroups based on generation, sex, interest, and function. The subgroups are
defined by boundaries indicating which individuals will be in the subgroup and how members in that subgroup will interact.
Minuchin conceptualizes families as operating according to a continuum of boundaries, from rigid boundaries that lead to
disengagement on one end, clear boundaries in the middle, and diffuse boundaries that lead to enmeshment on the other
end. Most families' boundaries fall into the normal range, but some of its subgroups may have elements of disengagement
and enmeshment as well. In dysfunctional families, however, there is normally a severe breakdown of one or more of the
subgroups within the family (10).
The rigid boundaries in Chinese families were functional in their native country, but in many instances that rigidity will
result in reinforcing dysfunctional family interactions in America. With most dysfunctional Chinese families, the goal of
therapy will not be to change subgroups of the family (normally there is appropriate clarity of the roles and expectations for
everyone) but rather to make more flexible the rigid boundaries between parents and children by modifying the
communication patterns so that individuals understood each other better. There must be, for example, hierarchy within the
parent-child subgroup, and parents must control the children. But, based on my experience in the United States (unlike
China), children, particularly adolescents, need to be heard when decisions are being made for them. A significant problem
in parent-child conflict is not attributed to the parental decision itself but to the feeling on the part of the child of being
either ignored, denied, or misunderstood. As a result, anger grows and in dysfunctional families is later exhibited in the
form of rebellion. A child who knows he is loved and feels he is understood will not usually display dysfunctional behavior.

Joining
Joining is an integral part of structural family therapy and continues throughout every session. It goes beyond
establishing a therapeutic relationship. It is the active effort on the part of the therapist to show the family members that he
or she cares for them as individuals and as a family; that he understands, sympathizes, and supports each of them; and that
he is like them in many ways. Joining enables the therapist to control the session without alienating any family member. In
joining with Chinese families, the therapist is aware of, and takes into consideration, the cultural values of each family
member.

Process
A myth exists among many beginning mental health professionals that insight will lead to change. Many individuals
recognize what is creating problems for them but for numerous reasons cannot, or will not, make the necessary changes.
Structural family therapists believe that involving clients in process or talking with each other rather than to the therapist,
coupled with assisting family members to interact in a different manner, can be a stronger treatment intervention than
education. Structural family therapists also believe that it is better to have family members involved in the process of
change rather than simply talk about change. In addition, process therapy is in many instances less threatening than an

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educational approach because the assumption is, and many clients recognize it, that if the therapist must educate, the clients
must be stupid or ignorant.
To examine the use or process, we can refer to the case illustration presented earlier in this article in which the Chinese
adolescent was referred to the agency because of school and behavioral problems.

As previously indicated, John's parents did not understand their son's behavior. They were not accustomed either to
elicit feelings and thoughts for him or verbally give support to him but instead believed they had the right to dictate
what he should and should not do. John viewed his parents as rigid, unsupportive, and uncaring. After joining with
all family members, the therapist asked Mr. W. if he would share with the therapist what he observed to be his son's
feelings and thoughts. Mr. W. said that he knew his son was angry, hurt, unhappy, rebellious, and stubborn. He
added that he was an intelligent boy and could go far if he used his intelligence wisely. The therapist then asked the
boy if his father was correct and when he said yes, asked if he had realized that his father knew him so well. He
replied no. The father was then asked what he expected of his son and why. He related the hardships he encountered
in this country: his difficulty making a living, his fear that American society would corrupt his son, his wish that his
son have a better life than he. John was then asked if he knew how much his father cared for him. He replied no but
that his father was old-fashioned and needed to recognize his son's need to make some decisions himself. The
therapist admonished the son for calling his father old-fashioned (thereby supporting the father) and for his
ignorance in not recognizing that his father, because of his traditional upbringing, could not express his feelings the
way Americans do (thereby indirectly educating the parents). He punctuated the fact that the important thing was
that his father did care and expressed that care in the only way he knew how. The son was then asked to express his
ideas and thoughts to his parents based on his own experiences (thereby reinforcing the son's right to be heard).
Through the support of the therapist, the father and son had a long discussion on a variety of issues. (This process
was the most important part of the therapy because the two were involved in a positive, and for the father, a new
experience). Although at the end of the session the father held to the rules he had previously set, the son began to
recognize that his father did care for him and that in some respects he was being understood. The father began to
learn more about his experience in America because he was not being attacked. Subsequent sessions helped father
and son continue interacting with each other in a positive atmosphere so that the son became respectful of his father,
knowing that he cared and wanted the best for him. The father learned more about his son and about American
society, became more flexible, and changed some of the rules on the basis that his son demonstrated responsibility.
After the relationship between the father and son improved, the therapist concentrated on the relationship between
the mother and son.

Not all family treatment will, of course, go as smoothly as the case presented above. The difficulties encountered in many
cases will not be primarily attributed to cultural differences and inability of parents to recognize feelings and to
communicate effectively. In more disturbed families, problems are due to more serious family dysfunctions such as
alcoholism, habitual gambling, wife-beating, thought disorder, irresponsibility of adults in not holding down a job,
pathological insecurity, etc. A dysfunctional family in China will be a dysfunctional family in America.

Problem-Solving
Because traditional Chinese families are not psychologically oriented, a problem-solving therapeutic approach, such as
structural family therapy, has been found to be useful. However, the model does not force the therapist to negate the validity
of psychoanalytic, ego psychology, gestalt, or other theories of growth, development, and change, nor does it prohibit the
use of practice principles based upon those theories. This is fortunate because there is no agreed-upon comprehensive
theory that adequately describes how individuals and families operate. Furthermore, while the constructs of a particular
theory may be accurate, the practice principles derived from those constructs may be inappropriate for some groups.
Although the structural therapy model allows for the diagnosis of family structure and interaction based on constructs from
numerous theories, therapists must be careful to utilize interventions that are relevant to the families with which they are
working. Accurate theory does not necessarily equate with accurate practice principles.
Structural family therapists emphasize having family members involved in a problem-solving process that will help bring
about immediate changes. Clients who seek assistance usually feel helpless and unable to resolve their own problems. The
goal of the therapist is to assist the family as quickly as possible in taking charge of their lives by achieving measurable
goals. Families will tend to return to therapy if they feel they are being helped and if changes are taking place. Techniques
utilized by structural family therapists are endless, and the more creative the therapist, the more ways she or he has to
intervene. Therapists utilizing this approach can be extremely imaginative as long as they respect the values of the family.
The following will illustrate the creativity and imagination of one therapist:

Mrs. L. was referred to the agency by the school because she complained to the teacher that she was having some
problems controlling B. her 16-year-old daughter. There were four younger children in the family, who had lived in

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the United States for nearly four years. Father could be of little help because he worked in a restaurant during most
of the hours the children were home. The presenting problems were that B. was becoming too Americanized and
that she came home late from school, was not helpful enough around the house, spoke English at home, and was
becoming interested in boys. During the course of one interview, mother said that her daughter had cooked dinner
the previous night but had cooked chicken American style rather than Chinese style. This indicated to mother that
she was becoming further Americanized. The therapist who made home visits, was always asked to stay for dinner.
During this interview, she agreed to stay on the condition that she buy two chickens, one to be cooked by mother,
who would show B. how to cook it Chinese style, and the scond to be cooked by B., who would show mother how
to cook it American style. The therapist would observe the cooking and then tell them which she liked best.

On the surface, the task appears to be inappropriate. If one examines it more closely, however, one can see that the
therapist has created a positive situation in which ideas between mother and daughter can be exchanged. The therapist also
did it in an atmosphere in which ideas are traditionally exchanged between mother and daughter? in the kitchen. Finally,
the therapist ensured that the task would be a positive experience, thus enabling mother and daughter to communicate in a
supportive rather than antagonistic manner. The task did not resolve all the differences between the two but within the
cultural context of the family did focus upon a problem defined by mother and provide a basis on which positive interaction
could be facilitated and sustained.

Focusing on Strengths
Structural family therapy is a growth model that focuses on strengths rather than on weaknesses in families. It is a
positive approach that attempts to build on a family's accomplishments rather than on its failures. This does not imply that
therapists are naïve and do not recognize weaknesses, but emphasis is on creating an atmosphere in which family members
are not threatened and therefore need not be defensive. Keeping this in mind, the therapist will be supportive of the parents'
traditional beliefs while at the same time attempting to modify them.

Therapist as Authority Figure

Experience has shown that traditional Chinese will respond more favorably to a mental health professional who asserts
his or her authority and is directive in the therapeutic process rather than one who appears immature and nondirective.
Structural family therapists accept the role of being the expert in helping families resolve their problems, while at the same
time respecting the dignity and abilities of each family member. Ideally, the therapist is always in control but not central to
the therapeutic process. This allows him or her to help facilitate planned interaction between family members that will lead
to desired changes. In addition to what was previously mentioned, he accomplishes this by continuously being aware of: (a)
the different family interactions that occur simultaneously throughout the session; (b) his position in relation to each family
member; and (c) his plan of action based on his family diagnosis.

Broad Applicability
Structural family therapy does not provide a panacea for all mental health problems. Its applicability is limited by the
mandates, organizational structure, and policies of agencies and institutions; the willingness of clients to participate in
family therapy; and the nature of the presenting problems. However, the model can be applied to most problems brought to
a mental health, child guidance, or family service agency. The assumption is made that the presenting problem, whether it
be anorexia, a phobia, thought disorder, alcoholism, drug abuse, parent-child conflict, school problem, or child abuse, is
reinforced by the family structure and repetitive patterns. Consequently, the structural family therapist is more concerned
with the family dynamics that reinforce the presenting problem than the presenting problem itself. The therapist will focus
upon problem resolution in the therapy session but will also be working toward changing the dynamics of the family that
are reinforcing the defined problem.

Summary
In summary, it can be stated that structural family therapy, for a variety of reasons, offers an appropriate treatment model
for dysfunctional Chinese families. Since the family, not the individual, is the more important unit in Chinese culture, the
model offers the opportunity for the total family to participate in changing dysfunctional individual and family patterns. The
model focuses upon structure, which is the essence of the Chinese family. In addition, it is problem- and growth-oriented,
creates a nondefensive atmosphere in which family members can change, and works toward helping family members
improve communication and modify behavior. It is important to stress that it does not focus upon helping family members
make significant changes in their value system. Furthermore, the model can be applied to most problem areas, because it is
assumed that the presenting problem is reinforced by family structure and repetitive patterns. Consequently, family
interactional patterns that reinforce the presenting problems are the major focus of the treatment. Finally, the model allows
for the utilization of theories and practice principles of other clinical approaches.

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Structural family therapists assume the role of authority figures who are experts in family therapy. They view the family
within the context of its environment, are sensitive to the cultural norms of the group with which they are working, and
utilize supportive services as an integral part of treatment. More important, therapists believe in the power of families to
make changes and work toward helping them become involved in a new process of interaction that will lead to satisfactory
changes.

REFERENCES
1. Brown, T. R. and Stein, K. M., et. al., "Mental Illness and the role of Mental Health Facilities in Chinatown," in S.
Sue and N. N. Wagner (eds.), Asian-Americans: Psychological Perspectives, Palo Alto, Calif., Science and
Behavior Books, 1973.
2. Chen, P., "The Chinese Community in Los Angeles," Soc. Casework, 51, 591-598, 1970.
3. Chernow, R., "Chinatown, their Chinatown: The Truth Behind the Facade," New York Magazine, June 11, 1973,
pp. 39-45.
4. Gordon, M. M., Assimilation in American Life: The Role of Race, Religion and National Origins, New York,
Oxford University Press, 1964.
5. Hsu, F. L., Americans and Chinese: Reflections on Two Cultures and Their People, Garden City, N.Y.,
Doubleday Natural History Press, 1970.
6. Kim, B. C. and Condon, M. E., "A Study of Asian-Americans in Chicago: The Socio-Economic Characteristics,
Problems and Service Needs," NIMH Grant No. 1 R01 MH23993-01, October 1975.
7. Lamson, H. D., Social Pathology in China, Shanghai, The Commercial Press, 1935.
8. Los Angeles County, Department of Health Services, Mental Health Services, Report No. 10, "Patient and Service
Statistics," 1973.
9. Matsushima, N. M. and Tashima, N., "Mental Health Treatment Modalities of Pacific/Asian American
Practitioners," NIMH Grant No. 1 R01 MH32148, September 1982.
10. Minuchin, S., Families and Family Therapy, Cambridge, Mass., Harvard University Press, 1974.
11. Sue, S. and Sing, D. W., "Chinese-American Personality and Mental Health," in S. Sue and N. N. Wagner (eds.),
op. cit.
12. Sullivan, C. and Hatch, K., "The Chinese in Boston," Action for Boston Community Development, Planning and
Evaluation Department, 1970.
13. United States, Department of Health, Education and Welfare, Social Security Administration, Bureau of District
Office Operations, Labor Relations and Equal Opportunity Staff, "Asian-Americans: A Case of Benighted Neglect
and the Urgent Need for Affirmative Action," October 1974.
14. Yang, M. C., A Chinese Village: Taitou, Shantang Province, New York, Columbia University Press, 1945.
Manuscript received July 26, 1983; Accepted November 29, 1983.
1Unless otherwise specified, the word Chinese will refer to Chinese in America.

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