Why Language and Culture Matter in Domestic Violence Services: Supporting Asian Survivors

1. Why Language and Culture Matter in Domestic Violence Services: Supporting Asian Survivors Doan Phan, LMSW Counselor and Program Manager

2. Mission: to promote abuse-free Asian communities through advocacy, support, awareness and access to social services.  AFSSA provides support to API and immigrant survivors ofdomestic violence, sexual violence and sex trafficking. Client services include: • Culturally grounded therapeutic services • Direct legal assistance • Crisis intervention and advocacy services • Long term case management addressing self-sufficiency needs Community-Based Initiatives: • Community Education and Outreach Program • Language Access Program • Systems Advocacy Program

3. Some terms I will be using today… API: includes Asian, Asian American, Native Hawaiian and Pacific Islander Refugee: someone who has been forced to flee his or her country because of persecution, war, or violence because of their race, religion, nationality, political opinion or membership in a particular social group Undocumented Immigrant: anyone who enters the country without inspection documents, including those who stay after the expiration of visas or someone in deportation proceedings Underserved: based upon the inherent attributes of the individuals in the population (such as gender identity, sexual orientation, age, race, ethnicity, etc.), but also a set of circumstances which may cause certain demographic groups to experience greater challenges in terms of accessing services/resources Limited English Proficient:(LEP) persons who are unable to communicate effectively in English because their primary language is not English and they have not developed fluency in the English language ***Please see definitions handout for more information***

4. Objectives for today 1. To strengthen your incorporation of culturally competent advocacy into everyday work with all of your clients 2. To develop more inclusive ways of exploring culture when working specifically with API clients 3. To understand and identify some of the unique needs of your API client 4. Discuss best practices for working with your API clients 5. Address language accessibility and organizational plans for accessibility

5. Keep in mind... There are always individual differences and group generalizations must be understood as an approximation. The Asian community is full of uniqueness and multiplicity.

6. ASIACommunities of Contrast

7. Basic facts about Asia & Asians in Texas Asia • More than 50 distinct ethnic and national origin subgroups • Over 2,000 languages and dialects are spoken throughout Asia South Asian Southeast Asian East Asian Central Asian West Asian Hawaiian and Pacific Islander

8. Basic facts continued… U.S. • 38% do not speak English fluently • 60% foreign-born • Fastest growing ethnic minority • Highest concentrations: California, New York, Hawaii, Texas, New Jersey Texas (2015) • 4.8% of the population • Predominant groups: Indians, Chinese, Filipino, Japanese, Korean and Vietnamese

9. What communities makes up the API population in your region or community?

10. Culture….what’s it all about??? Culture is… shared experiences or commonalities that have developed and continue to evolve in relation to changing social and political contexts, based on these intersections of identity: What other intersections can you think of?

11. Culture Matters! • Gives context and meaning • Color blindness is culture blindness Its about social justice! What happens if culture is ignored?

12. Cultural Competency is… • Individual and institutional practice • Continuous, life-long self-assessment regarding your own culture/privilege and the impact it has with those around you • Beyond cultural awareness (knowledge of another group) and cultural sensitivity (knowledge/awareness of another group)

13. Power, Privilege and Oppression • Everyone: more than a single cultural identity, thus, in different situations, varied experiences of privilege or oppression. • True cultural competence: understanding of social inequalities how it affects individuals and communities • Multiple social identities: we are all targets/agents of oppression

14. Culturally Competent Advocates… • Understand the importance/dynamics of culture • Knowledge of societal inequities • Build their cultural knowledge • Adapt services to meet cultural needs • Understand privilege and oppression

15. Domestic Violence is a complex issue…. Cultural and language issues can create additional barriers for our clients.

16. Culture and Trauma Culture influences: • If threat is perceived as traumatic • Interpretation of meaning of traumatic event • Expressions of trauma reactions • Understanding of when support is needed • How and from whom clients seek support Healing can only take place within a survivor’s specific cultural context

17. Cultural expressions of abuse in API communities Domestic violence is a universal problem, but its cultural expressions differ. Expressions:(not all-inclusive) Multiple batterers • Husbands, mothers-in-law, fathers-in-law, brothers-in-law, sisters-in-law, ex-wives, new wives; and/or members of a woman's natal family - her parents, aunts, uncles, adult siblings Push & Pull Factors • Being pushed out of the relationship or marital home ("leave the house, give me a divorce, I can always find another wife") more frequently than they are pulled or enticed back into it ("come back to me, I won't do it again")

18. Physical abuse • Multiple batterers in the home, including male and female in-laws • Homicide that can include honor killings, dowry related death • Hyper-exploitation of household labor Sexual abuse • Sexual violence in war zones, refugee camps • Sexually assaulted then forced to marry rapist • Forced abortion or sex-selective abortion • Abuser marries multiple women, coerced into unprotected sex • ‘Matter of law’ she has sex whenever he wants Emotional abuse • Isolating from family/community • Pressure from natal family to stay in relationship • Telling her she has abandoned her culture

19. Spiritual abuse • Using religion to justify abuse • Forced practice/limiting practice of particular religion Forced Marriage • Typically underage girl forced to marry significantly older men • Different than arranged marriage Immigration control • Threatening deportation • Withholding or hiding passports and other important documents • Transnational abandonment • Abusive international marriages • Financial abuse • Forcing her to sign forms she does not understand (legal, financial, etc)

20. Critical Issues of Access Barriers confronting API survivors: Cultural • Collectivistic society • Gender inequality • Religion • Cultural norms • Family Structure and the role of the extended family • Structural/Institutional • Economic

21. Potential Cultural Barriers Collectivism: emphasize family/community goals above individual needs or desires. One’s identity is grounded in connection with others. Duty to one’s family • Members role is clear and typically unchanging Obedience to parents/authorities • Parents’ may determine if client will stay/leave relationship Maintenance of interpersonal harmony • Avoidance of confrontation and indirect expressions of negative feelings • Clients may say ‘yes’ to your questions • Placing others’ needs ahead of one’s own

22. Honor/Shame or ‘saving face’ Desire to avoid embarrassment • Clients may not ask questions Risk of social isolation from community if one goes against the norms • Clients may never leave the abusive relationship Enforce cultural norms in preventing the reporting/admitting of ‘problems’ • Clients may not want to involve police or any other systems Cultural beliefs and values play an important role in how APIs define domestic violence and help-seeking behaviors.

23. Potential Cultural Barriers to Access Beliefs about sources of problem • Suffering is inevitable or that one's life span is predetermined Distrust of Western methods and medicine Mental Health may be tied to spirituality Role of religion • Gender roles • Rules within marriage • A context for belief systems and values

24. Model minority myth • 14% of US Asian families live below the poverty line • educational attainment varies among the subgroups • Hides the actual experiences of racism and prejudice • Notion of underutilization of mental health services = better health Institutional and Structural barriers • Language* • Lack of understanding of the role of provider • Believe all services connected to immigration/police services • Service providers lack understanding of the API’s cultural norms • Lack of disaggregated API data • Underrepresented in literature/empirically-based research • Experience of discrimination, racism, oppression

25. Language Barriers Language access is one piece of the big picture of cultural competency Inadequately trained interpreters Lack of adequate language skills or knowledge of ‘medicalese’ vocabulary • Respect for authority of advocate, politeness: may not ask questions Lack of linguistic equivalency: does the concept/word even exist? Somatic expression of psychological disorders making problems public associated with shame/humiliation, etc. • more acceptable to have physical complaints

26. What can you do? Utilize and respect role of hierarchy & family practitioner shows interest and become familiar with a client's background Prepare for some appropriate use of self-disclosure  Builds trust! Be aware of culturally specific communication techniques: • use of eye contact • integration of food in discussions • pace of conversation • body language

27. Be responsive to culture and embed this awareness in every conversation and decision for your API client • Acknowledge diversity of experience and strengths • loyalty and family obligations • parental sacrifice • spirituality • compassion • strong adherence to cultural values • Speak clearly and directly, but with patience • Client may expect you to solve the problem for them • Express an appreciation and respect for the clients culture strengths in coping with trauma • Incorporate aspects of Trauma-Informed Care into your work

28. Work to enhance personal self-awareness  Address own misconceptions, stereotypes and projections • To client: not concerned with immigration status and do not record this information** • May take longer to explain information to a client who is LEP • Don’t assume! client’s ethnic heritage and level of acculturation More info on language to come next…

29. LANGUAGE ACCESS

30. Addressing LEP Access Civil Rights Act of 1964—Title 6 Executive Order 13160: Nondiscrimination on the Basis of Race, Sex, Color, National Origin, Disability, Religion, Age, Sexual Orientation, and Status as a Parent in Federally Conducted Education and Training Programs Executive Order 13166: Improving Access to Services for Persons with Limited English Proficiency **Applies to all entities that receive federal funding**

31. Title VI-Civil Rights Act of 1964 Title VI of the Civil Rights Act ensures language access for individuals with limited English proficiency. Pursuant to Title VI’s prohibition against discrimination based on race, color, or national origin and organizations receiving federal financial assistance are required to develop and implement policies that ensure meaningful access for limited English proficient persons to their programs and activities.

32. Executive Order 13166: LEP Access to Federally Funded Programs • Law Enforcement • Courts • Social Service sgencies • Government agencies Does your agency receive any of the following? • VOCA • VAWA • FVPSA • DHS • OVC • Receive money from the state (HHSC, OAG)? Some of that state money is tied to federal funds!

33. Texas Administrative Code A center must: •   (1) serve people with limited English proficiency and take reasonable steps to ensure meaningful access to the program; and •   (2) develop, maintain, and comply with written policies and procedures for the access and delivery of services to people with limited English proficiency TAC shelter §379.608 TAC non-residential §379.2008 Do you know what your agency policy states?

34. Assessing your language needs Identify obstacles one might encounter when working with the immigrant population and/or LEP population Go through your intake process and imagine someone who speaks a non-English language • Points of contact-hotline, advocate, materials, directions, etcaccessible? • Translated materials? Output: What are the barriers? How many hours of language assistance do you need to give the most basic services?

35. After the Assessment What can you do? Budget funding for interpreters (in-house or through company) and bilingual staff Translate outreach materials to ensure access to basic services Translate vital forms: intake forms, etc. Have proper signage ***See handout***

36. ARE YOU SERIOUS?? How am I going to pay for this? Perceived challenges for non-profits: Lack of funds Lack of interpreters in the area

37. Building an accessible program Build a volunteer interpreter program Partner with interpreter and translator associations Build-in cost in all grant applications Develop policies around LEP access and interpreter usage

38. Building a volunteer interpreter program Recruit volunteers: Universities Civic groups Ethnic media Ethnic grocery stores and businesses Other ideas? Provide a training or partner with someone who can provide a training on ethics and boundaries

39. Before you work with interpreters Policies: • Interpreter vs. Advocate policy • CONFIDENTIALITY policy • ‘Outside’ interpreters: sign confidentiality • Address training Be aware of interpreters from smaller, insular communities Find out exactly which language/dialect your client speaks May be Burmese, but does not speak Burmese **See interpreter handout for more information.**

40. Caveats… DO NOT use children, parents, friends or relatives why? Try NOT to use neighbor or fellow community member • Survivor more reluctant to provide information, especially SA issues • Biased interpreters • May further endanger the victim

41. Resources and Tools Interpretation and Translation Language Line Pacific Interpreters (TCFV Pool) Masterword Google or Yahoo Translator** “I speak” cards

42. The Ultimate Goal… • Eliminating/reducing disparities • Eliminating/reducing disproportionalities • Improving access, availability, quality/appropriateness, accountability, utilization and outcomes

43. As an organization, are we inclusive of ALL Survivors? • Demographics • Who is entering your doors? • Who is not entering your doors? • Staff? • Current policies? • Programs/services in compliance HHSC? • Advocates trained  providing culturally grounded services?

45. THANK YOU! Asian Family Support Services of Austin www.AFSSAustin.org dphan@afssaustin.org The difference between social service and social justiceis that social service works to alleviate hardship while social justice aims to eradicate the root causes of that hardship.

46. National Resources and References www.apiidv.org www.apiahf.org www.minorityhealth.hhs.gov www.lep.gov http://www.ncbi.nlm.nih.gov/books/NBK340/ www.census.gov http://www.nami.org/Template.cfm?Section=Multicultural_Support1&Template=/ContentManagement/ContentDisplay.cfm&ContentID=115281 http://www.sagepub.com/upm-data/24161_Resource_Guide_for_Counseling_Asian_Clients.pdf http://www.sagepub.com/upm-data/4968_Paniagua_I_Proof_3_Chapter_5.pdf   http://counselingasianamericans.wordpress.com/multicultural-counseling-competencies/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071736/# http://www.mvcc.edu/counseling-center/counseling-office http://psychology.ucdavis.edu/aacdr/pubs/hall006.pdf