Sue, Stanley (1944-)

Scholarship

Sue has made significant theoretical and empirical contributions in the areas of ethnicity and mental health, cultural competency, and effective delivery of mental health services. His first major contribution was to document treatment disparities in mental health services for ethnic minorities. In his early collaboration with Herman McKinney in the 1970s, Sue analyzed the utilization patterns of nearly 14,000 clients seen in 17 community mental health agencies serving King County in the state of Washington. They found that ethnic minority clients tended to drop out from treatment at a higher rate and to have fewer average number of sessions than White clients. Based on this research, as well as on the consensus of other Asian American mental health providers, Sue made several policy recommendations to improve services for ethnic minorities, such as training therapists to be more knowledgeable about cultural bases of mental health, to recruit and hire more ethnic minority psychologists, to develop ethnic-specific mental health service centers, and to create new therapies and services that better meet the needs of ethnic minorities. These recommendations became fundamental building blocks for increasing cultural competence in mental health service delivery.

Sue's groundbreaking studies, which suggested that inadequate services were being provided to ethnic [Page 1344]Sue, Stanley (1944-) minorities, were initially challenged by the Washington State Department of Social and Health Services and Sue was asked to testify before the Washington State Senate subcommittee on mental health. After his successful defense of the scientific basis for the findings, many of Sue's policy recommendations were implemented in many areas of the country. In fact, Sue directed the training for the National Asian American Psychology Training Center in San Francisco in 1980, which was established specifically to train service providers in culturally competent practice with Asian Americans.

The early work documenting treatment disparities led Sue to pursue research on culturally competent services. In a 1987 paper, Sue and Nolan Zane proposed a theoretical model for treatment outcome based on various forms of match between therapists and clients. Sue and Zane contended that ethnic match between therapists and clients is important because ethnically matched therapists tend to have higher ascribed credibility with clients, but other factors (e.g., therapist-client match on problem conceptualization and goals, therapist behavior during the first session) contribute to achieved credibility that lead to better retention in treatment and more positive outcomes. In his 1998 paper, Sue articulated his hypotheses about three essential ingredients of cultural competency. In this paper, he argued that although culture-specific knowledge (e.g., making direct eye contact with an elder person would be considered disrespectful in a Chinese culture) was a necessary component, a culturally competent clinician must also demonstrate scientific mindedness (i.e., to treat such cultural-specific knowledge as a hypothesis rather than as a given in a particular client) and practice dynamic sizing (i.e., to know when to apply or not apply a particular culture-specific knowledge to assess and treat a particular client).

...