The Korean Conundrum: Managing stigma in the recruitment of group counseling members

1. The Korean Conundrum: Managing stigma in the recruitment of group counseling members Ji-yeon Lee, M.A., Stephanie Budge, M.A., Jennifer Wilson, M.A., Jenny Roper, M.A. University of Minnesota February 10, 2011

2. Presentation Overview • Overview of ethical considerations • Case example: Korean female international students • Contributing factors including cultural context • How we handled • Future Directions (e.g., prevention) • Discussion

3. Ethical considerations • Confidentiality • Selection/De-selection • Multicultural populations

4. Confidentiality • Limits in groups (Yalom, 2005; Appelbaum & Greer, 1993) • Fears about the lack of confidentiality • Gossip • Technological barriers • Casual encounters • Misunderstanding what is confidential information • Misunderstanding when information is confidential (within group boundaries)

5. Selection • Good group therapy begins with good client selections (Yalom, 2005, p. 231) • “The great majority of clinicians do not select for group therapy. Instead, they deselect” (p. 231). • This process tends to be based on clinical wisdom rather than empirically derived (Kincade, 2004)

6. Deselecting in College Counseling Centers • Severe psychopathology • Having a personality disorder • Being actively suicidal • Lack of fit with other members (Kincade, 2004)

7. Considerations for multicultural populations • Can be the ideal place to explore concerns process experiences of oppression and exclusion (Johnson, 2009; Lee, 1997) • May be asked to be the “spokesperson” for their group (Johnson, 2009) • When the community is small, the group members may see each other often (Lee, 1997) • Similar to a small college or small town, when you see another student frequently on campus, it is difficult to reveal personal information in the group (Kincade, 2004)

8. Similar challenges in other sub-groups: • LGBT community • International students from the same countries • Graduate students from the same programs • Individuals from the same residence hall or hometown

9. Specific Case in UCCS • Six South Korean women studying at U. of Minn.; seeking services at UCCS • Two open process groups; one Assertiveness Workshop • Potential members brought their concerns about joining during screening • Initial group meeting, appeared familiar with each other • Potentially transfer to alternate group; Korean co-facilitator

10. The Korean Conundrum: A B C Screened for WIG, wanted Grad Women Screened for Grad Women– In Mentioned B Screened for Grad Women, wanted Grad Women or Assert Mentioned A Screened for Assertiveness Workshop – In Screened for WIG – In Was an older undergraduate On first day of WIG, knew D. Decided to drop out. Considered USO group. Screened for WIG – In Discussed: will be other Korean in group during screening. Ok by D On first day of WIG, knew C. Decided to stay in WIG Screened for Assertiveness – In Despite the fact that 2 Korean women in Assertiveness Workshop, the issue never came up. It seemed to be a safe enough environment. Screened for Grad Women Asked if other Korean women in the group. Said she was not willing to join such a group, decided to do individual work Discussed Conundrum in Group Sup D E F

11. E F A B C D

12. Contributing Factors in the Cultural Context • Intern’s contribution to increasing awareness of UCCS services within Korean community • Cohesion of Korean community • Few Korean colleges; graduate students likely already knew each other from their undergraduate institutions in Korea • Small general population in Korea; events reported back become well-known in community

13. Sub-group Considerations • Multiple sub-groups within Korean community: • Graduate / Undergraduate • Asian-American / Korean International • Independently financed / Scholarship recipients • Male / Female

14. Different Social Norms • No secret • Gossip • Saving face -> reputation as a professional • Double standard in dating -> reputation as a potential marriage partner

15. Resolution • Expression of interest in two groups • Preference for Grad Women’s group • Self-chosen de-selection • Preference for individual counseling

16. Raised Awareness • Importance of supervision and peer consultation • Use of Korean intern as our “bridge-person” • Confront assumptions about specific communities • Lack of conversation about group therapy modality in multicultural training • Raised ethical considerations otherwise not discussed (i.e., confidentiality)

17. Future Directions • Address the issue within group screening • Questions of confidentiality/priming • Outreach to Korean communities on campus • Provide space at UCCS for social gatherings/support • International Student & Scholar Services—collaborate to decrease stigma

18. Discussion • Reactions to case; critique of resolution • Concerns with other populations • Similar experiences at other campuses? • Other service limitations • Confidentiality issues