Sexual Abuse in Nine North American Cultures: Treatment and Prevention
Publication Year: 1995
The impact of culture on sexual abuse issues is only beginning to be understood. In minority populations, sexual abuse can be overlooked - or survivors can be inappropriately treated - because of cultural or linguistic misunderstandings, racism or homophobia. This volume contains culture-specific chapters that consider ways in which cultural norms can be used to protect children and promote healing from sexual abuse.
- Front Matter
- Back Matter
- Subject Index
- Chapter 1: African Americans and Sexual Child Abuse
- Chapter 2: Puerto Ricans and Sexual Child Abuse
- Chapter 3: Asian, Pacific Island, and Filipino Americans and Sexual Child Abuse
- Chapter 4: Cambodians and Sexual Child Abuse
- Chapter 5: Jews and Sexual Child Abuse
- Chapter 6: Anglo Americans and Sexual Child Abuse
- Chapter 7: Seventh Day Adventists and Sexual Child Abuse
- Chapter 8: Gay Males and Sexual Child Abuse
- Chapter 9: Lesbians and Sexual Child Abuse
- Chapter 10: Culturally Informed Interventions for Sexual Child Abuse
BOOKS UNDER THE GENERAL EDITORSHIP OF JON R. CONTE, Ph.D.[Page ii]
- Hate Crimes: Confronting Violence Against Lesbians and Gay Men
- edited by Gregory M. Herek and Kevin T. Berrill
- Legal Responses to Wife Assault: Current Trends and Evaluation
- edited by N. Zoe Hilton
- The Male Survivor: The Impact of Sexual Abuse
- by Matthew Parynik Mendel
- The Child Sexual Abuse Custody Dispute: Annotated Bibliography
- by Wendy Deaton, Suzanne Long, Holly A. Magaña, and Julie Robbins
- The Survivor's Guide
- by Sharice A. Lee
- Psychotherapy and Mandated Reporting of Child Maltreatment
- by Murray Levine and Howard J. Doueck
- Sexual Abuse in Nine North American Cultures: Treatment and Prevention
- edited by Lisa Aronson Fontes
- Preventing Child Maltreatment Through Social Support: A Critical Analysis
- by Ross A. Thompson
- Intimate Betrayal: Understanding and Responding to the Trauma of Acquaintance Rape
- by Vernon R. Wiehe and Ann L. Richards
Copyright © 1995 by Sage Publications, Inc.
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Library of Congress Cataloging-in-Publication Data
Main entry under title:
Sexual abuse in nine North American cultures: treatment and prevention / edited by Lisa Aronson Fontes.
Includes bibliographical references and index.
ISBN 0-8039-5434-4 (acid-free paper).—ISBN 0-8039-5435-2 (pbk.: acid-free paper)
1. Child sexual abuse—United States—Cross-cultural studies.
I. Fontes, Lisa Aronson.
This book is printed on acid-free paper.
95 96 97 98 99 10 9 8 7 6 5 4 3 2 1
Sage Production Editor: Diana E. Axelsen
Sage Typesetter: Andrea D. Swanson
[Page v]This book is dedicated to the child whose first words to me were, “It is hard to be a 5-year-old named Jamie.” I hope you are safe.[Page vi]
I experienced my first quandary about race and class at the age of seven, when I was living with my extended family in Guanyaquil, Ecuador. The circumstances remain vivid as I describe them now. Chavita was a girl my age whose family had brought her to be raised by my grandmother. Chavita's family had limited resources and felt that she had a better chance of getting good care and an education with our family. In return, she would lead a life of service like her parents, grandparents, and extended family. Because she was so young, her job was to be my maid, my playmate, and my companion.
I did not realize there were strict boundaries imposed on my relationship with Chavita. So, when she cried because she missed her parents, I would comfort her; when she was frightened, I would reassure her. Slowly our friendship deepened, and I grew to love her as the sister I did not have. Chavita always seemed to sense what I did not: that others would disapprove intensely of our friendship. Often I noticed her withdraw when others observed our play from afar. During the night, we waited until my grandmother opened the door to check that we were asleep; then Chavita would climb into my bed. Before falling asleep, we often talked into the early hours of the morning; but Chavita always woke up in time to get on the floor where she was supposed to sleep.
One morning my grandmother found her sleeping with me and yanked her out of bed to be awakened by a harsh beating. “Who do you think you are?” she demanded. She threw Chavita out of the room and scolded me for allowing that “filthy child” to get into my bed. When I protested that I had asked Chavita [Page x]to sleep in my bed, my grandmother explained that we were not the same; Chavita was a servant, and I had to “command respect” or she would take advantage of me.
When I think about this shocking experience now, I realize that my grandmother's attitude toward Chavita was an expression of the Latin traditions that she had followed all her life. She was teaching me about race and class in the same way her mother had taught her. She was convinced that Chavita was somehow subhuman because her skin was darker than mine and because our family enjoyed a life of privilege, partly at the expense of those around us whose lot in life was to focus on our needs.
It's hard to know why children accept or reject the things they are taught by their elders—I've often wondered why my experience of that event shaped me in exactly the opposite way from what it was designed to do. Nevertheless, from the outside, I found it impossible to accept that people could be deemed inferior because of their skin color, gender, or class.
When I was 14, our family moved to the United States. I felt mortified that I was not allowed to have the traditional “coming out” party at 15 that I would have had in Ecuador. But at the same time, I was excited to return to Washington, DC, where I had lived for one year when I was younger.
I liked many things about living in America, particularly what I perceived as greater independence, which came about in part because our social status changed dramatically. In Ecuador, we were economically privileged, we had servants, and our mother stayed home. In the United States, there were no servants in our house; my brother and I were left alone until my mother returned from work; and most importantly, I had the freedom to choose my friends and my activities. Suddenly, my mother's efforts to restrict my contact to people of “my class” were no longer successful because I went to school with children from divergent cultures, ethnicities, and classes. In spite of some difficulties adapting to expectations that I clean my room, wash my clothes, and cook some of my meals, this lifestyle felt more congruent to me, and I'm sure these initial impressions influenced my later choice to remain in the United States.
The transition from life in Ecuador to life in the United States was fraught with a range of emotions, including tension, confusion, and significant feelings of inferiority and isolation. I was on the receiving end of racism for the first time in my life, and I empathized with Chavita even more. Kids laughed at my English and made fun of my name. Teachers called attention to me by asking me to pronounce my name. Eventually the school records changed my [Page xi]name to Elaine, and I was called by this name for years. In a way, the fact that it was easier to pronounce gave me the anonymity that signified acceptance. The most difficult change was feeling like an outsider who was thought to be less intelligent (often people who don't speak English are thought to be less bright) or who was always chosen last (almost as an afterthought).
Partly because children are resilient and partly because I gravitated toward the differences I perceived in the United States, I acculturated fairly quickly, so much so that I created tension at home when I asserted my independence by becoming verbally defiant. In the United States, most people assume that I am American unless I make a formal announcement that I am Latin. Many colleagues assume that I am American, because I no longer have an accent and because my skin color is not as dark as the U.S. mainstream stereotype of Latin people. I have become fully bicultural, able to walk in both worlds. This capacity to shift is a result of complex and varied processes, both unconscious and conscious, that clarify and verify the realities, nuances, and influences of culture.
To walk in both cultures means that my identity developed as a result of my integrating values, traditions, attitudes, beliefs, expectations, and histories of both cultures. I am as familiar with the political and social revolutions of my adopted country as I am with the struggles of my birth country. Cultural identity greatly influences individual identity formation, through exposure, identification, and experience. Initially, our truths are the truths of those around us, because the people around us direct our attention and define our thinking. Eventually, we may disagree with and discard part of the surrounding tradition, defining an identity entwined with but separate from our cultural heritage.
Culture is a concept that encompasses a great deal. It is tempting to think of culture as ethnicity; but cultures include diverse ethnicities, languages, and family structures; perceived differences among people based on class, gender and gender roles, or skin color; views of mainstream culture and its public agencies; political histories; moral and religious principles; lifestyles; child-rearing practices; the ways emotions are expressed; and who the accepted healers are. Culture also includes the ways individuals and communities regard issues of violence and sexual assault against its vulnerable members (who may be men), and what level of action is taken when violence and sexual assault occur. Cultures have unique narratives, unique ways of resolving survival and extinction issues, and composite identities which result from formative experiences. To separate an individual from his or her cultural background is like prying roots from the dirt that surrounds them.
[Page xii]Cultures convey expectations, make demands of their members, and provide more or less rigid rules with consequences for compliance or dissension. Individual differences may be encouraged, tolerated, or prohibited. In some cases, group norms are overridden in favor of protection of individual rights.
Sexual Abuse in Nine North American Cultures has been masterfully sculpted to give us individual perceptions of cultures by professionals who were influenced by and who currently provide services to families and communities in distress. It becomes painfully clear that individuals participate in collective histories of toil and redemption; along the way, unity becomes a strengthening strategy for survival. Individual pain and crisis must be viewed against the backdrop of sociocultural development, which often has a cumulative impact that can reinforce feelings of oppression, hopelessness, or futility.
There are unique aspects in every culture. The authors repeatedly encourage clinicians to affirm and strengthen their cultural competence, postulating that a thorough understanding of culture and of how individuals interact with their cultural heritage is critical in providing useful mental health services. Clinicians must take the initiative to research the cultural backgrounds of their clients; it is unrealistic to place this burden on troubled individuals seeking help. Fortunately, health care professionals, including the contributors to this book, are taking on this task. The authors have summarized relevant information which facilitates learning about a variety of cultures.
This book makes a significant contribution both by heightening awareness of cross-cultural issues and by augmenting a spotty knowledge base regarding child sexual abuse within different cultural groups. The field of child abuse prevention and treatment has maintained a simplistic approach to cross-cultural concerns, often ignoring ethnocultural information in research studies or treatment approaches. In some cases it has inadvertently contributed to stereotypes by demanding that cultural issues be appraised without offering specific training in how to make those appraisals. The end result is that professionals in the child abuse field (mental health, public health, law enforcement, medicine, and social work) either over- or underreact to cross-cultural diversity. It is as dangerous to exaggerate cultural differences to the point that there is a likelihood of overidentification of problems as it is to minimize them, relegating abusive behavior to expectable or tolerable behavior within cultures.
As diverse as cultures are, unifying themes contribute to the establishment of cultural identity. These themes include organization of the family unit; the [Page xiii]relative value of interdependence compared to autonomy and differentiation; the treatment of female sexuality; childrearing practices; work ethics; the relationship between religion and sexuality; gender roles; interpersonal boundaries; level of tolerance for emotionalism; and the extent to which cultures are ideocentric (organized around individual needs) or allocentric (group oriented). This book explores these themes as they are expressed in nine North American cultures.
Cultural issues are relevant to child sexual abuse in three major ways: how cultural beliefs or attitudes contribute to family climates in which children can be abused; how cultural organization prohibits or hinders disclosure; and how culture plays a role in seeking or accepting social service or mental health assistance. These issues must be addressed if families are to be helped. These three dimensions are amply discussed in this book, which offers invaluable insights that raise our consciousness in addition to providing specific strategies that can be implemented in practice. The book furthers our understanding of how cultural beliefs are both supported by and contribute to individual behaviors and family interactions. Specifically, when assessing the development of child sexual abuse within families, the authors argue for an ecosystemic view that discourages confining the focus to individuals and champions an amplified view of the individual as he or she interacts, adapts, or separates himself or herself from family, community, and cultural contexts.
This volume is provocative, personal, and professional; it is both abstract and concrete. It struggles with how to discuss the diversity within cultures without wavering from its overall goal of providing basic historical premises for diverse cultures. Although not all major ethnic groups in the United States are discussed, the book does provide a framework within which such work can be extended to cover, for example, Native American cultures. It also provides an uncharacteristic view of culture which reaches beyond race and ethnicity. For example, both homosexuality and Seventh-Day Adventists are discussed as unique cultures—these chapters are written with great candor and clarity. Such analysis is badly needed and in the future might be explored with respect to the culture of persons who are disabled and who struggle with the identification and treatment of child sexual abuse.
The contribution of the book is not only in the information it so aptly presents but also in the way it encourages the reader to think and in the assertion that clinicians must enlighten and empower themselves when working cross-culturally, approaching issues of culture with rigorous attention and sensitivity. Clinicians are challenged to recognize strengths and utilize the [Page xiv]internal resources of each culture, rather than pathologizing what is unfamiliar or imposing treatment goals that are inconsistent with or incongruous to individuals of diverse cultures. These internal resources include helpers such as indigenous healers; priests, rabbis, or ministers; curanderos; and incorporation of traditional healing rituals such as sweat lodges or sitting shivah. By drawing on these resources, clinicians optimize their chances of meeting their stated goal: to be of assistance to families so that the quality of their lives is improved and children are safe and nurtured.
Preface[Page xv]Lisa AronsonFontes
As a student in 1985 at a major teaching hospital in a Latino neighborhood in New York City, I attended grand rounds, where a case was presented of a 10-year-old Dominican girl who misbehaved in school, washed herself constantly, masturbated in public, and engaged in other behaviors that puzzled the multidisciplinary team that had been charged with her care. The team members discussed their various hypotheses and the medications that had been tried. Finally, a specialist in sexual abuse stood up in exasperation and suggested that this girl was showing classic signs of sexual molestation. The team leader looked irritated and, with an attitude of, “Why does this guy always raise that issue?” replied, “We could not really communicate with the family because the girl was the only one who spoke English, and that was minimal, but the father seemed like a nice guy so we ruled out sexual abuse.”
I was astounded. The team seemed to have no understanding of the “nice guy” veneer of many people who abuse children. Even more alarming was their willingness to attempt drastic interventions with little awareness of their patient's family, community, or cultural context. If this was the care given at one of the top settings in the country with a large Latino population, how were Latinos, immigrants, and members of other minority groups treated elsewhere? How many people experiencing sexual abuse were being overlooked or mistreated because of cultural or linguistic misunderstanding, or downright racism or homophobia? Additionally, I wondered about the ways in which culture affected people's experiences of sexual abuse.
[Page xvi]My experiences that morning set me on a path of research and clinical work that has now given birth to this book. Thankfully, we know much more about sexual abuse now than we did 10 years ago. However, the impact of culture on sexual abuse intervention is only beginning to form part of the discussion. At some conferences on sexual abuse today, practitioners can learn culturally sensitive approaches to child protection and therapy for sexual abuse. Increasingly sophisticated research is emerging about culture and sexual abuse. At conferences dedicated to multicultural therapy, however, issues of family violence and sexual abuse are still rarely broached.
The heart of this book is a collection of nine original chapters by authors from a variety of cultural groups who are experts in treating sexual abuse among members of their group. The culture-specific chapters present the strengths and challenges of each cultural group. They consider ways that cultural norms can be used to protect children and promote healing from abuse.
This book is solution oriented. Much of the culture-specific writing today seems to ascribe to a deficit-pathology model, stressing what appears to be “different” or “lacking” about cultures that are in the minority in the United States. Simultaneously, much writing about culture fails to examine or challenge the all-pervasive norms of the dominant United States culture. This book offers us opportunities to learn from minority cultures. The chapter on sexual abuse in Anglo American families also helps us understand the cultural contributions to sexual child abuse (and recovery!) that are written into the very fabric of the dominant culture—usually neglected as a culture because it surrounds us so completely.
Considering culture is crucial but not sufficient in the treatment of sexual abuse. We must also examine how social status due to sex, race, proficiency in English, economic class, religion, national origin, and sexual orientation partially determine the way people are treated by the various social systems that intervene when sexual abuse comes to light. After discussing cultural norms, each chapter discusses oppression issues that emerge in encounters with the social service system and how professionals can help families work to counteract this oppression.
The sexual abuse of children happens in all sectors of the population. Interventions that are tailored to the specific ways sexual abuse is handled by members of a given group—and the meanings people from that group ascribe to both the abuse and interventions—will be more effective than interventions that are “generic” (that is, based on the lives of heterosexual, middle-class, White, European American, Christian, female clients).
[Page xvii]In my introduction, I suggest ways in which culture can contribute to an ecosystemic context for understanding the prevention, occurrence, detection, and recovery from sexual abuse.
Nine chapters devoted to specific cultural groups follow. The word “culture” has been interpreted broadly here to mean people bound by common beliefs, history, and practices. Although it is somewhat unusual to include lesbian and gay male cultures on the same level as the other cultures discussed in this book, I believe readers will find these chapters helpful in thinking about the impact of history, discrimination, and group norms on interventions for sexual abuse with gay and lesbian clients and their families. These chapters complement the others by addressing the ways that sexual orientation affects experiences of sexual abuse. Each of us participates in a culture shaped by our sexual orientation, although most of the literature on sexual abuse assumes the heterosexuality of the people discussed rather than addressing sexual orientation explicitly.
In the concluding chapter, I discuss some of the general promises and pitfalls of attending to culture in providing services for sexual abuse. I offer a view on the general issue of matching clients and service providers for ethnicity (which is also discussed in culture-specific chapters), and provide some suggestions for those who set the policies that shape the lives of those who research and intervene in sexual child abuse, as well as those who are affected personally by it.
I commend the authors of these chapters for their courage. In conversations, e-mail, and letters, the authors described sleepless nights and knots in their stomachs as they risked writing publicly about a topic that most of us fear examining even with members of our own group: How does membership in my culture put children at risk for abuse?
Every culture has norms that raise the risk of sexual abuse for children, as well as values that have the potential to protect children from sexual abuse. How do we bring about change? The first step toward change is naming our oppression. In this case, individuals, families, communities, and the wider society must break through denial and label the sexual child abuse in our midst. The second step involves education: speaking out in all possible forums about the existence and harmful effects of sexual child abuse and involving people from all groups and professions in working to protect children and promote recovery. The third step, I believe, is for members of specific groups to organize to change the conditions of their own group that permit or foster sexual abuse. At the same time, members of all groups must band together to change the societal climate that allows sexual abuse to occur.
[Page xviii]Although this book discusses members of a variety of groups, it is not all inclusive. This book is meant to advance the discussion on culture and sexual abuse—it is not the last word. Shared contexts facilitate the growth of common coping strategies. Group similarities do not hinge on ethnic origin alone. Those who work with Central American refugees from war-torn countries, for example, may find the chapter on Cambodians as relevant as the chapter on Puerto Ricans. People who work with deaf clients may find important information on languages in the chapter on Puerto Ricans, as well as information on isolation from one's parents in the chapter on lesbians, for instance. In addition, you may find that a prevention or healing practice used by one group will spark ideas for work with your own group. Also, of course, we are all members of multiple reference groups based on our race, gender, class, ethnic origin, religion, sexual orientation, and other factors.
We are guilty here of what I call “ethnic lumping” (Fontes, 1993a). We have collapsed some groups into large categories. For instance, the chapter on Asians includes Chinese, Japanese, Koreans, Filipinos, and Pacific Islanders. Clearly, each of these groups merits a separate chapter, but that is not possible in this volume. In this book, there is only one chapter on Latinos, which focuses on Puerto Ricans. It will certainly inform readers who seek information on working with other Latinos, but there are differences. I do not believe there is one correct way to cut the pie that makes up North American society. The authors helped decide where they would draw the boundaries around their discussions, resulting in dynamic, authoritative, and liberating discussions.
Factors including social class, education, and degree of assimilation contribute to great variability within each of the groups discussed. Readers should proceed with caution in applying ideas suggested here to individual cases. Each individual and family must be assessed for their particular needs and their degree of adherence to cultural norms.
Discussions of culture, sex, and violence tend to put us all on the defensive. I hope readers will approach this book with an open and generous spirit, which is the spirit in which it was written. We hope you will communicate with us about what you like and do not like about it, and what works and does not work. Please let us know about your related local projects.
I am filled with gratitude to the contributors, a brilliant bunch who have worked diligently and have good-naturedly tolerated my numerous editorial suggestions. Thanks to Jerry Weinstein for sharing his computer skills. I am grateful to Carlos Fontes, Linda Baker, Roberto Irizarry, Catherine Taylor, and [Page xix]Kim Gerrould for their critiques of my work. I am grateful to Tom Herman for his nurturing encouragement; to C. Terry Hendrix, Jon Conte, and Diana Axelsen at Sage—a dream team; to Richard Baldwin, Janine Roberts, Gretchen Rossman, John C. Carey, and Lynn Hoffman for their mentoring and friendship; to my new Purdue “family” for the web of kind challenge which supports me now; and to the colleagues, faculty, students, clients, and friends who have been my teachers. I thank Muriel Fox, Shepard and Eric Aronson for their long-distance cheering, advising, and consoling. Ana Lua, Marlena and Carlos Fontes—you are endless sources of inspiration and the center of my universe.
We give this book to the world in the hope that it will help reduce violence within families and reduce the violence perpetrated by social service systems. It is an honor to participate in this process.[Page xx]
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About the Editor[Page 297]
Lisa Aronson Fontes, Ph.D., is Assistant Professor of Family Therapy at Purdue University in West Lafayette, Indiana, where she teaches about family violence, qualitative research, and other topics. She supervises family therapists and has worked as a family, individual, and group therapist in a variety of settings including managed care, emergency services, and protective outreach services. She researches multicultural issues in family violence, particularly with Latinos, and she is currently conducting related research with migrant farm workers in the U.S. and with shanty town residents in Chile. She also facilitates workshops for professionals on the impact of working family violence on their own personal lives. She is on the editorial boards of Child Maltreatment, The Journal of Feminist Family Therapy, and The Family Journal. She obtained her doctorate in counseling psychology from the University of Massachusetts in Amherst. She welcomes correspondence about matters related to this book.[Page 298]
About the Contributors[Page 299]
Veronica D. Abney is a clinical social worker on the staff and clinical faculty at the University of California, Los Angeles's Neuropsychiatric Hospital in Los Angeles. She is also in private practice, specializing in group and individual treatment of childhood sexual trauma. She is a candidate member of the Institute of Contemporary Psychoanalysis and is interested in the application of modern psychoanalytic theories in cross-cultural treatment. Her publications include articles on both the treatment of adult survivors of sexual child abuse and cross-cultural issues.
Doug Arey, L.I.C.S.W., is the codirector of Lambda Resources for Women and Men, a psychotherapy practice for gays, lesbians, and bisexuals in Northampton, Massachusetts. He received his master's degree in social work at the University of Connecticut in 1984 and worked for 8 years as a clinician on the sexual abuse treatment unit in community mental health centers in western Massachusetts before beginning his private practice and cofounding Lambda Resources in 1990.
[Page 300]Maryellen Butke, M.S.W., is currently completing her doctoral work at Smith College School for Social Work. She is in full-time private practice at Women's Psychotherapy Associates, a group practice specializing in the treatment of women clients. She leads workshops for sexual abuse survivors as well as for therapists who were abused. She worked for 6 years at Bradley Hospital, a child and adolescent psychiatric hospital in Providence, Rhode Island, where she ran the Sexual Trauma Clinic. She is an adjunct faculty member at Boston College and Smith College School for Social Work. Her particular interests include holistic treatment that integrates mind, body, and spirit, as well as the integration of psychotherapy and spirituality.
Lillian Comas-Díaz, Ph.D., is the Executive Director of the Transcultural Mental Health Institute and maintains a private practice of clinical psychology in Washington, DC. In 1989, she was the recipient of the American Psychological Association Committee on Women in Psychology's Award for Emerging Leader for Women in Psychology. She has published extensively on cross-cultural mental health, gender and ethnic factors in psychotherapy, the treatment of torture victims, international psychology, and Latin mental health. She has edited two books, Clinical Guidelines in Cross Cultural Mental Health and Women of Color: Integrating Ethnic and Gender Identities in Psychotherapy.
Joan M. Featherman, Ed.D., is a psychologist practicing in Greenfield and Northampton, Massachusetts. In addition to her private practice of therapy and consultation on sexual abuse, sexual harassment, and related issues, she provides psychotherapy and directs the Training Psychologist Internship Program at the Outpatient Clinic of ServiceNet in Northampton, Massachusetts. She is the author of “Factors Relating to the Quality of Adult Adjustment in Female Victims of Child Sexual Abuse,” an unpublished doctoral dissertation written at the University of Massachusetts at Amherst.
Eliana Gil, Ph.D., is Director of the Center for Advanced Clinical Development, a program of the Multicultural Clinical Center in Springfield, Virginia, where she provides clinical services, training, and supervision. She is founder and Senior Program Advisor of A Step Forward, a child abuse treatment and training program in Concord, California. She has written extensively on child abuse and related topics. Her books include Treatment of Adult Survivors of Childhood Abuse, United We Stand: A Book for Individuals With Multiple [Page 301]Personalities, and Outgrowing the Pain Together: A Book for Spouses and Partners of Adult Survivors. Her most recent books include Play in Family Therapy and (with Toni Cavanagh Johnson) Sexualized Children: Assessment and Treatment of Sexualized Children and Children Who Molest. She is a well-known lecturer and a frequent guest on local and national television and radio shows. She is bilingual and bicultural, orginally from Guayaquil, Ecuador.
Patricia Heras, Ph.D., is a Filipino American clinical psychologist in private practice in San Diego with expertise in the areas of child abuse, posttraumatic stress disorder, depression, anxiety disorders, and cross-cultural assessment and treatment. She obtained her doctorate from the California School of Professional Psychology, San Diego, where she is an adjunct faculty member. She provides training and consultation for mental health providers and organizations in cross-cultural issues. She serves as a special consultant to the San Diego Juvenile Court, chairs the Cross Cultural Task Force of the San Diego Psychological Association, and serves as a board member on the California Psychological Association Foundation. She has published on cultural considerations in the treatment of sexual abuse and on the acculturation of Filipino Americans.
Theanvy Kuoch is a survivor of the Cambodian holocaust and former refugee who worked in the German Surgical Ward in Khao-I-Dang, caring for people with war injuries and leprosy. She holds a master's degree in family therapy and is the Program Director of Khmer Health Advocates, Inc., which she cofounded in 1982. As a therapist, she has treated hundreds of survivors of the Mahantdorai. As an advocate for mental health and human rights, she has spoken internationally, urging that mental health problems be addressed as a major concern in the rebuilding of Cambodia. In 1989, she helped found Cambodian Mothers for Peace as a vehicle for giving voice to the suffering and strengths of Cambodian women. She also works for the Connecticut Department of Health in the refugee and tuberculosis programs.
Richard A. Miller is a psychiatrist who has worked with Khmer Health Advocates, Inc., for more than a decade. He is part of the therapy team that offers a weekly mental health clinic for Cambodians, and he provides medical care and advocacy for KHA. He received his medical degree from Case Western Reserve Medical School in 1969, interned at Baylor Medical School in Houston, Texas, and completed his residency in psychiatry at the Institute [Page 302]of Living in Hartford, Connecticut. In addition to his private practice, he is also the medical director of the Child and Family Agency of Southeastern Connecticut, Inc. He has given presentations on the psychiatric problems of Cambodian refugees, and his letter on fluoxetine treatment for posttraumatic stress disorder was published in the American Journal of Psychiatry.
Amy Okamura, M.S.W., L.C.S.W., is a “sansei” Japanese American educator and therapist. She is a faculty member at the San Diego State University School of Social Work and also has a private practice. She is a Board Certified Diplomate in Clinical Social Work with 25 years of clinical practice with Asian Pacific and Filipino populations in San Diego. She has developed and managed comprehensive services for immigrants and refugee children and their families in child abuse and mental health, educated and encouraged many ethnic minority individuals to pursue careers in social work, and trained hundreds of professionals in providing culturally competent therapeutic services. She is a consultant to the People of Color Leadership Institute and cochair of the San Diego County Mental Health Ethnic Diversity Resource Team.
Ronnie Priest, Ph.D., has worked in the specialty area of child victimization for 10 years. He has published in nationally recognized professional journals and presented workshops, institutes, and seminars related to child sexual victimization and diversity. He is currently an Assistant Professor in the Department of Counseling, Educational Psychology and Research at the University of Memphis in Memphis, Tennessee.
Marian Schmidt, Ph.D., is a licensed psychologist working as a consultant to mental health agencies in Kennebec/Somerset counties in Maine, and holding private practice in Skowhegan, Maine. She previously authored a chapter on WASP mothers for the Journal of Feminist Family Therapy (1990). She originated and conducted successful art therapy programs involving parents and children in at-risk families in both New Jersey and Maine. She is a certified addictions specialist and holds clinical membership in the American Association for Marriage and Family Therapy and the American Society of Clinical Hypnosis.
Mary Scully, R.N., C.S., is a Psychiatric Nurse Specialist who has 20 years of experience in cross-cultural psychiatric nursing. She was a member of the [Page 303]lead medical team that opened a camp for 20,000 Cambodian refugees in 1980 and was responsible for establishing psychiatric services. In 1982, she cofounded Khmer Health Advocates, Inc., where she is currently working as Executive Director in addition to her work as therapist and advocate. She has coproduced two ATOD prevention videos for Cambodians and has been responsible for archiving thousands of original documents about the Cambodian trauma experience and Cambodian health issues.
Catherine Taylor, L.I.C.S.W., works as a family therapist at People's Bridge Action in Athol, Massachusetts, and is also in private practice. She developed and coordinates the MOSAIC Project for mothers of children who have been abused sexually. This project includes support groups, videos, an internationally distributed newsletter, consultations, and peer advocates. She teaches and consults to Seventh Day Adventists in the North Atlantic region.
Linda Wong-Kerberg is a Chinese American licensed marriage, family, and child therapist. She is currently the Executive Director of the Center of Women's Studies and Services in San Diego. She received her master's degree in counseling from San Diego State University. She has directed three multicultural child abuse treatment programs in northern and southern California, two of which served predominantly Asian and Pacific Island children and families. Her expertise is in the area of sexual abuse treatment of Asian children, and she conducts trainings in California and nationally on clinical and cultural aspects of prevention, interventions, and cultural competency in child abuse.