The term Asian/Pacific Islander Americans is used by the U.S. Census Bureau to denote over 51 groups of people. Among these, 30 are Asians and 21 are Pacific Islanders. The ten largest Asian groups are identified in the Census. They include, in descending order by size, Chinese, Filipino, Japanese, Indian, Korean, Vietnamese, Cambodian, Hmong, Laotian, and Thai. Twenty other smaller Asian groups are usually listed as "other Asians," including an "Asian-not specified" category. The Pacific Islander groups identified in the Census include Hawaiian, Samoan, and Guamian, whereas eight other groups are typically listed as "Other Pacific Islanders." In a cultural competence training program, the first step is to recognize that Asian Americans and Pacific Islander Americans need to be discussed as separate groups due to the differences in their cultural heritage. Their combination under a general label is simply a matter of bureaucratic convenience.
Looking at Asian Americans alone, one has to recognize that many of the countries in Asia share common cultural traditions. Historically, China in the East and India in the South were the two centers of civilization in the region. Their cultures strongly influenced those of their neighbors and other countries in Asia. As such, instead of discussing the cultures of each individual Asian American group, it is reasonable to discuss them under the general labels East Asian, South Asian, and Southeast Asian, the latter group often reflecting differing degrees of East and South Asian cultural heritage. It should be emphasized that we are talking of cultural traditions rather than political entities or nations. For example, no researcher or scholar will deny the fact that the cultures of China, Korea, and Japan all share the core influence of Confucianism, Buddhism, and Taoism. However, this is very different from saying that a Chinese is "just the same" as a Japanese or a Korean, or vice versa. Countries belonging to the same cultural heritage still have their individual national pride, as well as a history of wars, conflicts, or rivalries. Many people from these countries will likely find it to be offensive to be considered a national of another country, if done deliberately. Herein lies the sensitivity of cultural competence training. On one hand, we can discuss common cultural elements shared by different groups. On the other hand, we need to be sensitive to national and ethnic pride, especially as professed by immigrants and their descendants in the United States. Sometimes, the insistence in being identified as distinct groups rather than being given general labels is a result of a common desire for ethnic recognition rather than an indication of major cultural differences.
Until recently, the term Asian American, especially in the mental health literature, referred mainly to East Asians, such as Chinese Americans, Japanese Americans, and Korean Americans. These three were among the largest "visible" Asian groups with a long history of presence in the United States. Asian Indian Americans were not included as "Asian" in the Census until 1980, and Southeast Asians did not arrive in large numbers until the 1980s. The number of Filipino Americans also increased significantly during this period. Being the more "Americanized" group of all Asian immigrants, Filipino Americans were historically not given much attention in the discussion of cultural adaptation in mental health services for Asian Americans. Although overall, the East Asian groups still represent the vast majority of Asian Americans, it is now crucial to include a discussion of the South Asian groups, as well as that of Southeast Asian groups. It is also important to identify the cultural heritage of the Philippines as the most westernized of the Asian countries, sharing the influence of Spanish and American cultures, and those of neighboring Asian countries.
In addition to the major cultural traditions of Asia, it is necessary to examine the issue of traditional Asian cultures versus contemporary Asian cultures as practiced there today (Hong & Ham, 1994). This should also include regional differences, especially between the metropolitan or major urban centers, which are usually more westernized, versus the rural areas, which are usually more traditional. It is also important to discuss Asian cultures versus Asian American cultures, with the latter often reflecting a mixture of Asian and mainstream cultures.
As applied to actual training, we can introduce the subject matter of Asian American mental health issues by identifying the major groups covered by the generic label Asian Americans, and discuss the usefulness of this label as used in different contexts. The major cultural traditions, namely East Asian, South Asian, and Southeast Asian can then be discussed in general, along with the precautions on regional differences or adaptation to United States society. This will give students and trainees the foundation to go deeper into specific groups as warranted by their professional work. Depending on the nature or purpose of the training program, the presentations and discussions can cover details on specific groups that the trainees are more likely to encounter, for instance, due to the demographics of the geographical region where they will be practicing. Trainees can also be instructed to read or research further on issues relating to particular Asian American groups in which they are personally interested, or with which they anticipate working. In this manner, rather than being overwhelmed by the diversity among Asian Americans, trainees will find the subject matter more palatable and useful.
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