Defense Date
2025
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Clinical Psychology
First Advisor
Jared Keeley
Abstract
As the rates of diverse ethnic populations and therefore cultural concepts of distress continue to grow in the United States, it becomes critical to learn and understand how western-trained mental health professionals are selecting treatments and implementing them. However, there is a paucity of research on cultural concepts of distress as a whole and much less on the psychotherapy of cultural concepts of distress in the United States. This exploratory study aimed to explore the treatment plan of mental health clinicians in the United States when encountering the Korean cultural concept of distress, hwabyung. Ninety-eight clinicians were recruited from Arkansas, Minnesota, Nevada, Rhode Island, and Vermont. All recruited clinicians were asked to read two vignettes, a control generalized anxiety disorder vignette and a hwabyung vignette. The participants were asked to provide a detailed narrative of their treatment approach for the corresponding vignette. Participants were then asked to select all symptoms of the disorder which led to their treatment approach. The same ordering of questions was asked for the second vignette. After the completion of the vignettes, they then completed other measures: Forunda’s Cultural Humility Scale (CHS) and the Self-Construal Scale to assess their level of cultural humility and their cultural orientation toward individualism or collectivism, respectively. The study was concluded by participants answering demographic and background questions (e.g., clinical and cultural information). Qualitative results indicated some areas of concern, such as invalidation of patient’s experiences, assumptions of patient’s culture, and misremembering of symptoms. The study also brought attention to the positive aspects of the therapy practice of these clinicians such as the strong incorporation of supportive counseling and validation. The study observed Western clinicians’ treatment approaches to cultural concepts of distress and showed areas that are in dire need of improvement for the well-being of patients and also highlighting strengths of clinicians that should continue to be fostered.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
11-13-2025