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A review of the acculturation experiences of international students

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Predictors of international students’ psychosocial adjustment to life in the United States: A systematic review

(2003). Psychotherapy Relationships That Work: Therapist Contributions and Responsiveness to Patients. Psychotherapy Research: Vol. 13, No. 4, pp. 529-532.

Psychotherapy relationships that work: therapist contributions and responsiveness to patients.

One of the most important goals of U.S. higher education is to encourage the enrollment of international students for academic, economic, and cultural purposes. The successful recruitment of these students comes with the responsibility to welcome, serve, and maintain the well-being of international students, and also to create an environment for multicultural interaction with students in the United States (hereinafter referred to as American students; Peterson, Briggs, Dreasher, Homer, & Nelson, 1999). Marion (1986) suggested that international students may act as great resources for increasing global understanding and the perspectives of American students. Peterson et al. found that American students learned about different cultures, their histories, and international issues from foreign students. In addition, they learned to acknowledge and respect cultural and individual differences and broaden their perspectives, thereby preventing stereotypical thinking. Marion also suggested that international students play an important role in providing technological knowledge to less developed countries. In the United States, enrollment of international students has been encouraged for the economic contribution of nearly $13.5 billion every year that they spend on tuition, living expenses, and related costs (Institute of International Education, 2007). The United States has the largest number of international students who represent many countries. During the academic year of 2005-2006, there were approximately 600,000 international students from several nations, with Asian students representing 58% of all international students, followed by students from Europe (15%), Latin America (11%), Africa (6%), the Middle East (4%), and 6% from North America and Oceania (Institute of International Education, 2007). Adjustment to a new educational and social environment can be a stressful process. Most college students experience stress throughout this process. However, many international students experience even more serious stress because of the additional culture shock factor (Church, 1982) and various sociocultural factors that are involved in the adjustment process of international students (Luzio-Lockett, 1998). It is not surprising that international students often face language barriers, immigration difficulties, culture shock, social adjustment, and homesickness. During this period of adjustment, international students may experience isolation and loneliness. Mori (2000) reported that these negative experiences can cause the students to feel hopeless, and an intensive sense of hopelessness may be the manifestation of depression. Considering the cultural differences and misunderstandings of the new and diverse experiences, it is likely that international students will experience feelings of estrangement, anxiety, and depression as a part of their adjustment process (Adler, 1975). Spielberger (1966) reported that anxiety is related to stress, and Furukawa (1997) reported that people who are exposed to foreign cultures may become depressed or anxious and display maladaptive behaviors as a result of this acculturative stress. Understanding the experiences of international students has important implications for creating and implementing programs that provide academic and personal support. Therefore, it is crucial to increase awareness about international students' problems and to recognize the students' individual perspectives regarding the factors that are involved in the adjustment and adaptation process (Luzio-Lockett, 1998). Because of these concerns, a number of studies have focused on the academic, psychological and social effects on international students of studying and living in the United States (Marion, 1986). In one of these studies, Kilinc and Granello (2003) found that students who were less acculturated experienced significantly more difficulty in their academic life, with language, and with medical/physical health than did the students with higher levels of acculturation. …

Predictors of Depression and Anxiety Among International Students

Background The college years represent a period of increased vulnerability for a wide range of mental health (MH) challenges. The onset of common psychiatric conditions occurs during this period of development. Increases in depression, anxiety, and suicidality among U.S. college students have been observed. This study identified prevalence and correlates of MH diagnoses and suicidality in a recent sample of U.S. college students. Methods The Spring 2015 American College Health Association-National College Health Assessment (ACHA-NCHA) survey assessed MH diagnoses and suicidality from U.S. undergraduate students (n = 67,308) across 108 institutions. Results Stress was strongly associated with a greater likelihood of suicide attempts and MH diagnoses, even among students reporting 1-2 stressful events (OR [odds ratio] range 1.6-2.6, CI [confidence interval] = 1.2-3.2). Bisexual students were more likely to report MH diagnoses and suicidality, compared to heterosexual and gay/lesbian students (OR range 1.5-3.9, CI = 1.8-4.3), with over half engaging in suicidal ideation and self-harm, and over a quarter reporting suicide attempts. Transgender students reported a higher rate of MH diagnoses and suicidality relative to females (OR range 1.9-2.4, CI = 1.1-3.4). Racial/ethnic minority students were generally less likely to report MH diagnoses relative to Whites, although the likelihood for suicidality was mixed. Conclusions The high rate of multiple stress exposures among the U.S. college population and the high impacts of stress on MH and suicidality point to an urgent need for service utilization strategies, especially among racial/ethnic, sexual, or gender minorities. Campuses must consider student experiences to mitigate stress during this developmental period.

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The prevalence and predictors of mental health diagnoses and suicide among U.S. college students: Implications for addressing disparities in service use.

This study examined the effects of acculturation, beliefs about mental illness, and selected demographic variables on the help-seeking attitudes of 120 Turkish students who were attending college in the United States. the authors maintain that if mental health professionals increase their understanding of Turkish international students, they can then develop more effective services for this population. International students attend more than 2,500 U.S. institutions of higher education, and there are more international students enrolled annually in universities in the United States than in any other country in the world. During the 2000-2001 academic year, the number of international students enrolled in U.S. colleges and universities was 547,867, 3.9% of the total enrollment in U.S. higher education. This represents the highest number of international students ever enrolled in the United States, a 6.4% increase over the previous academic year (Institute of International Education, 2002). Because of the high cost of pursuing an education in the U.S. for these students (typically 4 times as expensive as for domestic students) and because of immense pressure to succeed academically from their families, sponsoring organizations, or governments, international students may be at particular risk for stress-related mental and physical difficulties (Aubrey, 1991). Findings from previous studies supported the notion that international students, as a whole, are more at risk for both physical and psychological problems than are their domestic counterparts. International students often face language barriers, immigration difficulties, culture shock, social adjustment, loneliness, and homesickness (Mon, 2000). In spite of these difficulties, international students underutilize college counseling centers, and when they do seek counseling, they are often dissatisfied and tend to drop out prematurely (Mori, 2000; Zhang, 2000). Reasons include a cultural value orientation that discourages seeking professional help, as well as differing cultural perceptions of mental health and mental illness (Manheim, 1996). Thus, it is essential to provide counseling to international students that is sensitive and congruent with their cultural values and worldviews (Brinson & Kottler, 1995). Mental Health and Mental Illness in Turkish Students In the present study, college students from Turkey were surveyed to better understand their overall life satisfaction and their help-seeking attitudes and behaviors. Turkey now ranks ninth among countries that send college students to study in the U.S. each year. The number of Turkish students in the U.S. has increased significantly to 10,983 in 2000-2001, an increase from 4,978 in 1992-1993 (Institute of International Education, 2002). In spite of the increasing numbers, the Turkish student population in the U.S. has rarely been studied, and not much is known about the adjustment problems and help-seeking behavior of these students (Towle & Arslanoglu, 1998). The general lack of knowledge about perceptions of mental health and mental illness and ways of coping among Turkish individuals has been linked to the relatively new status of the psychological and psychiatric professions in Turkey (Yazgan, 1997). The few available studies of attitudes of Turkish students were conducted in Turkey. Taken together, these studies suggested that Turkish college students do not fully understand on-campus counseling services because they have not been exposed to these services at universities in their home country. Demir and Aydin (1996) and Guneri and Skovholt (1999) noted that Turkish students did not know the function of counseling and were reluctant to use the services when they were provided. Erkin (1994) reported that 51% of students at the Middle East Technical University in Turkey lacked information about the function of the counseling center, although when informed of the services, 94% stated that they had high or moderate needs for them. …

Overall Life Satisfaction and Help-Seeking Attitudes of Turkish College Students in the United States: Implications for College Counselors.

The authors review the literature on meaning and purpose in life as it relates to models of individual wellness. An overview of wellness models illustrates the importance of a sense of meaning to wellness. Suggestions are provided for how counselors may work with clients' sense of meaning in therapy. ********** The general public and health care practitioners have become increasingly interested in finding alternative paradigms to the biomedical model (Gordon, 1981; Granello, 2000; Gross, 1980; Still, 1986; Witmer, 1985; Wulff, Pedersen, & Rosenberg, 1990). In contrast to the biomedical model, wellness is a paradigm that has a salutogenic (i.e., health enhancing) focus (Ardell, 1977; Deliman & Smolowe, 1982; Dunn, 1961; Johnson, 1986; Opatz, 1986; Ryff & Singer, 1998; Tubesing, 1979). The general public's interest in wellness has continued to grow. For example, a study (Eisenberg et al., 1993) on the use of alternative practices to traditional medicine found that, in the previous year, one third of Americans used a treatment that could be classified as unconventional (e.g., acupuncture, massage). In addition, 75% of the spending for these treatments (the total of which was $13.7 billion) was out of pocket (Eisenberg et al., 1993). Possibly in response to the interest expressed by the general public, more mental health practitioners and physicians are adopting holistic medicine practices as part of their approach to patient care (Pert, 1997). The National Institutes of Health, in reaction to the growing practice and scientific interest in this area, opened its Office of Alternative Medicine in 1992 (recently renamed the National Center for Complementary Medicine and Alternative Medicine) to promote the study of wellness, holistic practices, and adjunctive medical services. Despite this increased interest by both the general public and the health care community, there is currently no clear definition of a well person (Granello, 1995,1999). The World Health Organization (1958) included some definitional characteristics in a 1947 statement saying that health is "a state of complete physical, mental, and social well-being, not merely the absence of disease" (p. 1). This definition supports the idea that if an individual is to be considered healthy, there are discrete spheres of human functioning in which the individual must strive to achieve health or wellness. Dunn (1961) characterized wellness as a "dynamic striving" inherent in individuals that drives them to achieve their highest potential. From a therapeutic practice perspective, Westgate (1996) noted that the holistic implication of the wellness perspective was that one could not treat one component of a person without knowing the balance of all components. One characteristic of an individual that has been suggested as being an important sphere of functioning in wellness models is having meaning and purpose in life. The purpose of this article is to review the literature related to meaning in life and wellness. It is beyond the intended scope of this article to define meaning or purpose or to review implied definitions from the literature. Rather, we review the proposed functions and benefits for individuals having such qualities (i.e., meaning and purpose) and their relationship to individual wellness. INCLUSION OF MEANING AND PURPOSE IN WELLNESS MODELS Several authors have proposed models in an attempt to define the specific physical, psychological, and social characteristics of a well person, and all of these models place emphasis on meaning and purpose in life (Hettler, 1986; Sweeney & Witmer, 1991; Zimpfer, 1992). Zimpfer proposed a wellness model based on his treatment of clients with cancer. His model includes seven areas of treatment important for client wellness: medical health, immune function, lifestyle management, spiritual beliefs and attitudes, psychodynamics, energy forces, and interpersonal relations. …

The Function of Meaning and Purpose for Individual Wellness.

In this article, the authors provide the counselor wishing to work with incarcerated adolescents with background information relating to the current scope of the problem and the current state of the juvenile justice system in the United States. The authors also review the current research regarding juvenile delinquency and outline a series of clinical techniques. The authors close by providing a developmental framework for enhancing the understanding of and guiding treatment for this difficult population.

Incarcerated and Court-Involved Adolescents: Counseling an At-Risk Population

Research and literature in the profession of counselor supervision primarily focus on the development of the trainee and what supervision and supervisors can do to help foster that development. Considerably less attention has been paid to the developmental path of the supervisor or how specific training or experiences in supervision can be used in intentional ways to help influence the development of the supervisor. This article reviews what is known about supervisor development and discusses a specific intervention, the use of a peer consultation model with an intentionally diverse group of supervisors, to enhance supervisor cognitive development.

Multiple Perspectives in Supervision: Using a Peer Consultation Model to Enhance Supervisor Development

Mental health practitioners are increasingly being called on to evaluate the effectiveness of the treatment they provide. The partial hospitalization component of the mental health industry also has felt this call for outcome research. This article presents the results of one program's attempts to answer that call through an assessment of treatment outcome and client satisfaction at a partial hospitalization program. Participants (N=287) were evaluated at admission, discharge, and 3-month follow-up. The article outlines the procedures used for assessment and uses the results as an example of the type of data that can be obtained through outcomes measurement. The article is intended to provide an example of program evaluation that is easy and inexpensive to administer.

Paul F. Granello

Papers

Overall Life Satisfaction and Help-Seeking Attitudes of Turkish College Students in the United States: Implications for College Counselors.

The Function of Meaning and Purpose for Individual Wellness.

Incarcerated and Court-Involved Adolescents: Counseling an At-Risk Population

Multiple Perspectives in Supervision: Using a Peer Consultation Model to Enhance Supervisor Development

Measuring treatment outcomes and client satisfaction in a partial hospitalization program.