Issues in Counseling South Asian Americans

  • Farah A. IbrahimEmail author
  • Jianna R. Heuer
Part of the Cross-Cultural Research in Health, Illness and Well-Being book series (CCRHIWB)


This chapter addresses counseling issues related to promoting health among South Asian Americans in medical settings. The chapter will review cultural issues relevant to seeking help pertaining to physical or mental health issues, and the experiences of South Asian Americans in medical settings. We explore the influence of culture of origin, language issues, and assumptions about allopathic medicine versus homeopathic, or Ayurvedic medicine. A brief review of the diseases that South Asians are at risk for will also be presented. Factors that put South Asians’ at risk for physical and mental disorders will be explored, including, the role of diet and exercise, medical literacy, stress of migration, adaptation to US culture, acceptance and rejection, loss of known familial and extended support systems, and work-related stressors. The primary issue of interest in this chapter is adherence to medical advice to manage chronic diseases and the processes that could lead to success for health care professionals.


South Asians Health risks Counseling issues 


  1. Abate, N., & Chandalia, M. (2001). Ethnicity and type 2 diabetes: Focus on Asian Indians. Journal of Diabetes and its Complications, 15(6), 320–327.PubMedGoogle Scholar
  2. Ahmed, K., & Bhugra, D. (2007). Depression across ethnic minority cultures: Diagnostic issues. World Cultural Psychiatry Review, 47–56 Retrieved from:
  3. Alden, D. L., Friend, J., Schapira, M., & Stiggelbout, A. (2014). Cultural targeting and tailoring of shared decision making technology: A theoretical framework for improving the effectiveness of patient decision aids in culturally diverse groups. Social Science & Medicine, 105, 1–8.Google Scholar
  4. Alegria, M., Takeuchi, D., Canino, G., Duan, N., Shrout, P., Meng, X. L., et al. (2004). Considering context, place and culture: The national latino and asian american study. International Journal of Methods in Psychiatric Research, 13(4), 208–220.PubMedPubMedCentralGoogle Scholar
  5. Ali, S. (2014). Identification and approach to treatment of mental health disorders in Asian American populations. In S. Parekh (Ed.), The Massachusetts General Hospital textbook on diversity and cultural sensitivity in mental health, current clinical psychiatry (pp. 31–59). New York: Springer Science+Business Media.Google Scholar
  6. American Association of Marriage and Family Therapy. (2015). Code of ethics. Alexandria: American Association of Marriage and Family Therapy.Google Scholar
  7. American Counseling Association (ACA). (2003). Advocacy competencies. Alexandria: American Counseling Association.Google Scholar
  8. American Counseling Association (ACA). (2014). Ethical code. Alexandria: American Counseling Association.Google Scholar
  9. American Psychiatric Association. (2013a). The principles of medical ethics with annotations especially applicable to psychiatry. Arlington: American Psychiatric Association Accessed 24 June 2015.Google Scholar
  10. American Psychiatric Association. (2013b). The diagnostic and statistical manual of mental disorders (DSM-5, 5th). Arlington: American Psychiatric Association.Google Scholar
  11. American Psychological Association. (2010). Ethical principles of psychologists and code of conduct. Washington, DC: American Psychological Association.Google Scholar
  12. Anderson, N. L. R., Boyle, J. S., Davidhizar, R. E., Giger, J. N., McFarland, M. R., Papadopoulos, T., Purnell, L., Spector, R., Tilki, M., & Wehbe-Alamah, H. (2010). Cultural health assessment. Journal of Transcultural Nursing, 21(Supplement I), 3075–3365.Google Scholar
  13. Atri, J., Falshaw, M., Livingstone, A., & Robson, J. (1996). Fair shares in healthcare? Ethnic and socioeconomic influences on recording of preventive care in selected inner London general practices. British Medical Journal, 312, 614–617.PubMedGoogle Scholar
  14. Balarajan, R., Yuen, P., & Soni, R. V. (1989). Ethnic differences in general practitioner consultations. British Medical Journal, 299, 958–960.PubMedGoogle Scholar
  15. Ballenger, J. C., Davidson, J. R., Lecrubier, Y., Nutt, D. J., Kirmayer, L. J., Lepine, J. P., Lin, K. M., Tajima, O., & Ono, Y. (2001). Consensus statement on transcultural issues in depression and anxiety from the international consensus group on depression and anxiety. Journal of Clinical Psychiatry, 62(S13), 47–55.PubMedGoogle Scholar
  16. Banaji, M. R., & Greenwald, A. G. (1995). Implicit gender stereotyping in judgments of fame. Journal of Personality and Social Psychology, 68, 181–198.PubMedGoogle Scholar
  17. Banaji, M. R., & Hardin, C. D. (1996). Automatic stereotyping. Psychological Science, 7, 136–141.Google Scholar
  18. Barnett, A. H., Dixon, A. N., Bellary, S., Hanif, M. W., O'Hare, J. P., Raymond, N. T., et al. (2006). Type 2 diabetes and cardiovascular risk in the UK South Asian community. Diabetologia, 49, 2234–2246.PubMedGoogle Scholar
  19. Becerra, M. B., Herring, P., Marshak, H. H., Banta, J. E. (2014). Generational differences in fast food intake among South-Asian Americans: Results from a population-based survey. Preventing Chronic Disease, 11. Retrieved from:
  20. Bennett, G. G., Wolin, K. Y., Robinson, E. L., Fowler, S., & Edwards, C. L. (2005). Perceived racial/ethnic harassment and tobacco use among African American young adults. American Journal of Public Health, 95(2), 238–240. Scholar
  21. Berry, J. W. (1997). Immigration, acculturation, and adaptation. Applied Psychology: An International Review, 46(1), 5–68.Google Scholar
  22. Betsch, C., Bohm, R., Butler, R., Haase, N., Hermann, B., Igarashi, T., et al. (in press). Improving medical decision making and health promotion through culture-sensitive health communication – An agenda for science and practice. Medical Decision-making (accepted July 2015).Google Scholar
  23. Bharmal, N. H. (2012). Acculturation and religiosity as moderators of cardiovascular disease risk among South Asians in the United States. Doctoral dissertation, UCLA. Accessed 15 June 2016.
  24. Bhopal, R. S., Phillimore, P., & Kohli, H. S. (1997). Inappropriate use of the term asian: An obstacle to ethnicity and health research. Journal of Public Health Medicine, 13, 244–245.Google Scholar
  25. Bhugra, D. (2004). Migration, distress and cultural identity. British Medical Bulletin, 69, 1–13.Google Scholar
  26. Bhugra, D., & Mastrogianni, A. (2004). Globalisation and mental disorders. Overview with relation to depression. British Journal of Psychiatry, 184, 10–20.PubMedGoogle Scholar
  27. Bhugra, D., & Becker, M. A. (2005). Migration, cultural bereavement, and cultural identity. World Psychology, 4(1), 18–24 Accessed 10 June 2016.Google Scholar
  28. Brown, J. B., Harris, S. B., Webster-Bogaert, S., Wetmore, S., Faulds, C., & Stewart, M. (2002). The role of patient, physician and systemic factors in the management of type 2 diabetes mellitus. Family Practice, 19(4), 344–349. Scholar
  29. Castillo, R. J. (1997). Culture and mental Illness: A client-centered approach. Pacific Grove, CA: Brooks/Cole.Google Scholar
  30. Cochrane, R., & Sasidharan, S. V. (1996). Mental health and ethnic minorities: A review of the literature and implications for services. In W. Ahmed, T. Sheldon, & O. Stuart (Eds.), Ethnicity and Health. New York: NHS Centre for Reviews and Dissemination (Report 5).Google Scholar
  31. Currer, C. (1986). Concepts of mental well- and ill-being: The case of Pathan mothers in Britain. In C. Currer & M. Stacey (Eds.), Concepts of health, illness and disease: A comparative perspective (pp. 236–251). Leamington Spa: Berg.Google Scholar
  32. Dana, R. J. (1998). Understanding cultural identity in intervention and assessment. Thousand Oaks, CA: Sage.Google Scholar
  33. Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F., Urbanowski, F., Harrington, A., Bonus, K., & Sheridan, J. F. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65, 564–570.PubMedGoogle Scholar
  34. DiMatteo, D. R., Lepper, H. S., & Croghan, T. W. (2000). Depression is a risk factor for noncompliance with medical treatment: Meta-analysis of the effects of anxiety and depression on patient adherence. JAMA Internal Medicine, 160(14). Scholar
  35. Fenton, S., & Sadiq-Sangster, A. (1996). Culture, relativism and the expression of mental distress: South Asian women in Britain. Sociology of Health & Illness, 18(1), 66–85.Google Scholar
  36. Gonzalez, J. S., Esbitt, S. A., Schneider, H. E., Osborne, P. J., & Kupperman, E. G. (2011). Psychological issues in adults with Type 2 Diabetes. In S. Pagoto (Ed.), Psychological co-morbidities of physical illness: A behavioral medicine perspective. New York: Springer Science Business Media. Scholar
  37. Ford, E. S. (2005). Risks for all-cause mortality, cardiovascular disease, and diabetes associated with the metabolic syndrome: A summary of the evidence. Diabetes Care, 28, 1769–1778.Google Scholar
  38. Garber, A. J. (2004). The metabolic syndrome. Medical Clinics of North America, 88, 837–846.PubMedGoogle Scholar
  39. Groce, N. (1992). Comparative and cross-cultural issues. Disability Studies Quarterly, 10(1), 1–39.Google Scholar
  40. Groce, N., & Zola, I. K. (1993). Multiculturalism, chronic illness, and disability. Pediatrics, 91(5), 1048–1055 Accessed 10 June 2016.PubMedGoogle Scholar
  41. Gujral, U. P., 1 R. Pradeepa, I. R., Weber, M. B., Venkat Narayan, K.M. & Mohan, V. (2013). Type 2 diabetes in south asians: Similarities and differences with white Caucasian and other populations. Annals of the New York Society of Sciences, 1281, 51–63.Google Scholar
  42. Gupta, R., Deedwania, P. C., Gupta, A., Rastogi, S., Panwar, R. B., & Kothari, K. (2004). Prevalence of metabolic syndrome in an Indian urban population. International Journal of Cardiology, 97(2), 257–261.PubMedGoogle Scholar
  43. Haeri, N. (1997). The Sociolinguistic Market of Cairo: Gender, Class and Education. London and New York: Kegan Paul International.Google Scholar
  44. Henry, H. M., Stiles, W. B., & Biran, M. W. (2005). Loss and mourning in immigration: Using the assimilation model to assess continuing bonds with native culture. Counselling Psychology Quarterly, 18(2), 109–119. Scholar
  45. Hsu, S. (1999). Somatisation among asian refugees and immigrants as a culturally-shaped illness behaviour. Annals of the Academy of Medicine, Singapore, 28(6), 841–845.PubMedGoogle Scholar
  46. Hussain, F. A., & Cochrane, R. (2002). Depression in South Asian women: Asian women’s beliefs on causes and cures. Mental Health, Religion & Culture, 5(3), 285–311.Google Scholar
  47. Ibrahim, F. A. (2008). The cultural identity check list (revised). Denver, CO: Copy written document.Google Scholar
  48. Ibrahim, F. A. (2010). Innovative teaching strategies for group work: Addressing cultural responsiveness and social justice. Journal for Specialists in Group Work, 35(3), 271–280.Google Scholar
  49. Ibrahim, F. A. (2014, June). Counseling South Asian Americans and International Students. Invited two-day training for Texas A&M College Counseling World Conference. College Station, TX.Google Scholar
  50. Ibrahim, F. A. (2015, January). Counseling South Asian American immigrants. Presentation at the APA National Multicultural Counseling Summit. GA: Atlanta.Google Scholar
  51. Ibrahim, F. A., & Arredondo, P. M. (1986). Ethical standards for cross-cultural counseling: Counselor preparation, practice, assessment, and research. Journal of Counseling and Development, 64, 349–352.Google Scholar
  52. Ibrahim, F. A., & Dykeman, C. (2011). Muslim-Americans: Cultural and spiritual assessment for counseling. Journal of Counseling and Development, 89, 387–396.Google Scholar
  53. Ibrahim, F. A., & Heuer, J. R. (2016). Cultural and social justice counseling: Client specific interventions. New York: Springer Business+Science Media.Google Scholar
  54. Ibrahim, F. A., & Ingram, M. A. (2007). Counseling South Asian international students. In R. Singaravelu & M. Pope (Eds.), Counseling international students (pp. 195–211). Alexandria: ACA Press.Google Scholar
  55. Ibrahim, F. A., & Ohnishi, H. (2001). PTSD and the minority experience. In D. Pope-Davis & H. Coleman (Eds.), Intersection of race, class, and gender in multicultural counseling (pp. 89–126). Thousand Oaks: Sage.Google Scholar
  56. Ibrahim, F. A., Ohnishi, H., & Sandhu, D. (1997). Asian-American identity development: South Asian Americans. Journal of Multicultural Counseling and Development, 25, 34–50.Google Scholar
  57. Implicit Association Test (IAT). (2011). Accessed 24 June 2016.
  58. Ivey, A. E., Pedersen, P. B., & Ivey, M. B. (2008). Group Microskills: Culture-centered group process and strategies. Alexandria: American Counseling Association.Google Scholar
  59. Ivey, A. E., Ivey, M. B., & Zalaquett, C. (2018). Intentional interviewing and counseling: Facilitating client development in a multicultural world. Boston, MA: Cengage.Google Scholar
  60. Jackson-Triche, M. E., Sullivan, G. J., Wells, K. B., Rogers, W., Camp, P., & Mazel, R. (2000). Depression and health-related quality in ethnic minorities seeking care in general medical settings. Journal of Affective Disorders, 58, 89–97.PubMedGoogle Scholar
  61. Jonnalagadda, S. S., & Diwan, S. (2002). A Brown Paper: The Health of South Asians in the United States. Retrieved from: Google Scholar
  62. Katon, W., Ries, R. K., & Kleinman, A. (1984). The prevalence of somatization in primary care. Comprehensive Psychiatry, 25, 208–215.PubMedGoogle Scholar
  63. Kessler, L. G., Cleary, P. D., & Burke, J. D., Jr. (1985). Psychiatric disorders in primary care: Results of a follow-up study. Archives of General Psychiatry, 42, 583–587.PubMedGoogle Scholar
  64. Kessler, R. C., Berglund, P. A., Bruce, M. L., Koch, J. R., Lask, E. M., Leaf, P. J., et al. (2001). The prevalence and correlates of untreated serious mental illness. Health Services Research, 36, 987–1007.PubMedPubMedCentralGoogle Scholar
  65. Kessler, C., Wischnewsky, M., Michalsen, A., Eisenmann, C., & Melzer, C. (2013). Ayurveda: Between religion, spirituality, and medicine. Evidence-Based Complementary and Alternative Medicine. Scholar
  66. Kirmayer, L. J. (2001). Cultural variations in the clinical presentation of depression and anxiety: Implications for diagnosis and treatment. Journal of Clinical Psychiatry, 62, 22–28.PubMedGoogle Scholar
  67. Kirmayer, L. J., & Young, A. (1998). Culture ad somatization: Clinical epidemiological and ethnographic perspectives. Psychosomatic Medicine, 60, 420–430.PubMedGoogle Scholar
  68. Kleinman, A. (1987). Anthropology and psychiatry: The role of culture in cross-cultural research in illness. British Journal of Psychiatry, 151, 447–454.PubMedGoogle Scholar
  69. Krause, I. B. (1989). Sinking heart: A Punjabi communication of distress. Social Science and Medicine, 29(4), 563–567.PubMedGoogle Scholar
  70. Lakhanpaul, M., Bird, F., Manikam, L., Culley, L., Perkins, G., Hudson, N., Wilson, J., & Hudson, M. (2014). A systematic review of barriers and facilitators to improving asthma management in South Asian children. Biomedical Central Public Health, 14, 403 Scholar
  71. Landrine, H., & Klonoff, E. A. (1996). The schedule of racist events: A measure of racial discrimination and a study of its negative physical and mental health consequences. Journal of Black Psychology, 22(2), 144–168.Google Scholar
  72. Laws, A., Jeppesen, J. L., Maheux, P. C., Schaaf, P., Ida Chen, Y. D., & Reaven, G. (1994). Resistance to insulin-stimulated glucose uptake and dyslipidemia in Asian Indians. Arteriosclerosis and Thrombosis, 14(6), 917–922.PubMedGoogle Scholar
  73. Lecrubier, Y. (2001). Prescribing patterns for depression and anxiety worldwide. Journal of Clinical Psychiatry, 62, 31–36.PubMedGoogle Scholar
  74. Lesser, I. A., Gasevic, D., & Lear, S. A. (2014). The association between acculturation and dietary patterns of south Asian immigrants. PLoS One, 9(2), e88495. Scholar
  75. Li, C., Ford, E. S., Zhao, G., Strine, T. W., Dhingra, S., Barker, L., et al. (2009). Association between diagnosed diabetes and serious psychological distress among U.S. adults: The behavioral risk factor surveillance system, 2007. International Journal of Public Health, 54, S43–S51.Google Scholar
  76. Lin, H. B., Carter, W. B., & Kleinman, A. M. (1985). An exploration of somatization among Asian refugees and immigrants in primary care. American Journal of Public Health, 75(9), 1080–1084.PubMedPubMedCentralGoogle Scholar
  77. Lovegrove, J. A. (2007). CVD risk in south Asians: The importance of defining adiposity and influence of dietary polyunsaturated fat. Proceedings of the Nutrition Society, 66, 286–298.PubMedGoogle Scholar
  78. Marsico, G., & Varzi, A. (2016). Psychological and social borders: Regulating relationships. In J. Valsiner, G. Marsico, N. Chaudhary, T. Sato, & V. Dazzani (Eds.), Psychology as a science of human being: The Yokohama Manifesto, Annals of Theoretical Psychology (Vol. 13, pp. 327–335). Geneva: Springer.Google Scholar
  79. Martin, J. K., Tuch, S. A., & Roman, P. M. (2003). Problem drinking patterns among African Americans: The impacts of reports of discrimination, perceptions of prejudice, and “risky” coping strategies. Journal of Health and Social Behavior, 44(3), 408–425.PubMedGoogle Scholar
  80. McKeigue, P. M., Pierpoint, T., Ferrie, J. E., & Marmot, M. G. (1992). Relationship of glucose intolerance and hyperinsulinaemia to body fat pattern in south Asians and Europeans. Diabetologia, 35, 785–791.PubMedGoogle Scholar
  81. McSwan, K. L. (2000). The impact of sexism on older women’s mental and physical health (Doctoral dissertation, Loma Linda University). Dissertation Abstracts International, 61(6B), 3323.Google Scholar
  82. Mezuk, B., Eaton, W. W., Albrecht, S., & Golden, S. H. (2008). Depression and type 2 diabetes over the lifespan: A meta-analysis. Diabetes Care, 31(12), 383–390.Google Scholar
  83. Misra, R. (2011). Epidemiology, risks, and complications of type 2 diabetes mellitus. In R. Misra (Ed.), Indian foods: AAPI Guide to nutrition health and diabetes (2nd ed., pp. 6–10). Chennai: Allied Publishers Private. Ltd.Google Scholar
  84. Misra, A., & Vikram, N. K. (2007). Metabolic syndrome in children and adolescents: Problems in definition, and ethnicity-related determinants. Diabetes and Metabolic Syndrome: Clinical Research and Reviews, 1(2), 121–126.Google Scholar
  85. Mosely, C., & Asher, R. E. (1994). Atlas of the world languages. London: Routledge.Google Scholar
  86. National Association of Social Workers. (2008). Code of ethics. Washington, DC: National Association of Social Workers.Google Scholar
  87. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2014). Insulin resistance and prediabetes. Accessed 15 June 2016.Google Scholar
  88. Nazroo, J. Y. (2001). South Asian people and heart disease: an assessment of the importance of socioeconomic position. Ethnicity & Disease, 11, 401–411.Google Scholar
  89. Nichter, M. (1981). Idioms of distress: Alternatives in the expression of psychosocial distress: A case study from South Asia. Culture, Medicine, and Psychiatry, 5(4), 379–408.Google Scholar
  90. Njobvu, P., Hunt, I., Pope, D., & MacFarlane, G. (1999). Pain amongst ethnic minority groups of South Asian descent in the United Kingdom. Rheumatology, 38, 1184–1187.PubMedGoogle Scholar
  91. Palaniappan, L.P., Araneta, M. R. G., Assimes, T. L., Barrett-Connor, E. L., Carnethon, M. R., Criqui, M. H., Fung, G. L., Narayan, K. M. V., Patel, H., Taylor-Piliae, R. E., Wilson, P. W. F., Wong, N. D. (2010). AHA health advisory. Call to action: Cardiovascular disease in Asian Americans. Accessed 14 September 2015.Google Scholar
  92. Paradies, Y. (2006). A systematic review of empirical research on self- reported racism and health. International. Journal of Epidemiology, 35(4), 888–901.PubMedGoogle Scholar
  93. Parkes, C. M., Laungani, P., & Young, B. (1997). Death and bereavement across cultures. London: Routledge.Google Scholar
  94. Pascoe, E. A., & Smart Richman, L. (2009). Perceived discrimination and health: a meta-analytic review. Psychological Bulletin, 135(4), 531–554. Scholar
  95. Patel, J. (2012). To assimilate or to acculturate? Experience and Other Evidence Essays. University of Maryland English Department. Accessed 8 June 2016.
  96. Patel, N. R., Chew-Graham, C., Bundy, C., Kennedy, A., Blickem, C., & Reeves, D. (2015). Illness beliefs and the sociocultural context of diabetes self-management in British South Asians: A mixed methods study. BMC Family Practice, 16, 58–69. Scholar
  97. Pedersen, P. B., & Ivey, A. E. (2003). Culture-centered exercises to teach basic group skills. Canadian Journal of Counselling, 37(3), 197–204.Google Scholar
  98. Phinney, J. S., & Ong, A. D. (2007). Conceptualization and measurement of ethnic identity: Current status and future directions. Journal of Counseling Psychology, 54, 271–281.Google Scholar
  99. Pumariega, A. J., Rothe, E., & Pumariega, J. B. (2005). Mental health of immigrants and refugees. Community Mental Health Journal, 41(5), 581–597. Scholar
  100. Qiu, S., Sun, Z., Cai, Z., Liu, L., & Yang, B. (2012). Improving patients’ adherence to physical activity in diabetes mellitus: A review. Diabetes Metabolism Journal, 36, 1–5. Accessed 8 October 2015.CrossRefPubMedPubMedCentralGoogle Scholar
  101. Raj, S. (2011). Introduction. In R. Misra (Ed.), Indian foods: AAPI guide to nutrition health and diabetes (2nd ed., pp. 1–5). Chennai: Allied Publishers Private. Ltd.Google Scholar
  102. Ratts, M. J., Singh, A. A., Nassar-McMillan, S., Butler, S. K., & McCullough, J. R. (2015). Multicultural and social justice counseling competencies. Accessed 24 June 2016.Google Scholar
  103. Rogers-Sirin, L., Ryce, P., & Sirin, S. R. (2014). Acculturation, acculturative stress, and cultural mismatch and their influences on immigrant children and adolescents’ well-being. In R. Dimitrova et al. (Eds.), Global perspectives on well-being in immigrant families (pp. 11–30). New York: Springer Science+Business Media.Google Scholar
  104. Ryan, A. M., Gee, G. C., & Griffith, D. (2008). The effects of perceived discrimination on diabetes management. Journal of Health Care for the Poor and Underserved, 19, 149–163.PubMedGoogle Scholar
  105. Sartorius, N., Üstün, T., Lecrubier, Y., & Wittchen, H. U. (1996). Depression comorbid with anxiety: Results from the WHO study on psychological disorders in primary health care. British Journal of Psychiatry, 168(30), 38–43.Google Scholar
  106. Sattar, N., & Gill, J. M. R. (2015). Type 2 diabetes in migrant south Asians: Mechanisms, mitigation, and management. The Lancet Diabetes and Endocrinology, 3(12), 1004–1115. PubMedGoogle Scholar
  107. Sikand, G. (2011). In R. Misra (Ed.), Indian foods: AAPI guide to nutrition health and diabetes (2nd ed., pp. 11–22). Chennai: Allied Publishers Private. Ltd.Google Scholar
  108. Simão, L. M. (2012). The other in the self: A triadic unit. In J. Valsiner (Ed.), The Oxford handbook of culture and psychology (pp. 403–420). New York: Oxford University Press.Google Scholar
  109. Simmons, D., Williams, D. R. R., & Powell, M. J. (1989). Prevalence of diabetes in a predominantly Asian community: Preliminary findings of the coventry diabetes study. British Medical Journal, 298, 18–21.PubMedGoogle Scholar
  110. Smith, T. B., & Silva, L. (2011). Ethnic identity and personal well-being of people of color. A meta-analysis. Journal of Counseling Psychology, 58, 42–60.PubMedGoogle Scholar
  111. Tan, C., Chew, S., & Tai, E. (2004). The metabolic syndrome: An Asian perspective. International Congress Series, 1262, 546–549.Google Scholar
  112. Thakore-Dunlap, U., & Van Velsor, P. (2014). Group counseling with South Asian immigrant girls: Reflections and commentary of a group facilitator. The Professional Counselor, 4(5), 505–518.Google Scholar
  113. Tummala-Narra, P., Inman, A. G., & Ettigi, S. P. (2011). Asian Indians’ responses to discrimination: A mixed-method examination of identity, coping, and self-esteem. Asian American Journal of Psychology, 2(3), 205–218.Google Scholar
  114. Tziomalos, K., Weerasinghe, C. N., Mikhailidis, D. P., & Seifalian, A. M. (2008). Vascular risk factors in South Asians. International Journal of Cardiology, 128, 5–16.PubMedGoogle Scholar
  115. Walsh, F., & McGoldrick, M. (2004). Living beyond loss: Death in the family (2nd., Ed.). New York: W. W. Norton.Google Scholar
  116. Weiss, M. G., & Ramakrishna, J. (2006). Health-related stigma: Rethinking concepts and interventions. Psychology Health Medicine, 11(3), 277–287. Scholar
  117. Wheeler, S., & Izzard, S. (1997). Psychodynamic counsellor training—Integrating differences. Psychodynamic Counselling, 3, 401–417.Google Scholar
  118. Williams, D. R., & Mohammed, S. A. (2009). Discrimination and racial disparities in health: Evidence and needed research. Journal of Behavioral Medicine, 32, 20–47.PubMedGoogle Scholar
  119. Williams, D. R., Neighbors, H. W., & Jackson, J. S. (2003). Racial/ethnic discrimination and health: Findings from community studies. American Journal of Public Health, 93(2), 200–208.PubMedPubMedCentralGoogle Scholar
  120. Wilson, M., & Maccarthy, B. (1994). Consultation as a factor in the low rate of mental health service use by Asians. Journal of Psychological Medicine, 20, 113–119.Google Scholar
  121. World Health Organization (WHO). (2003). Adherence to long term therapies: Evidence for action. Geneva: World Health Organization.Google Scholar
  122. Yen, I. H., Ragland, D. R., Grenier, B. A., & Fisher, J. M. (1999). Workplace discrimination and alcohol consumption: Findings from the San Francisco muni health and safety study. Ethnicity & Disease, 9(1), 70–80.Google Scholar
  123. Yoshikawa, H., Wilson, P. D., Chae, D. H., & Cheng, J. (2004). Do family and friendship networks protect against the influence of discrimination on mental health and HIV risk among Asian and Pacific Islander gay men? AIDS Education and Prevention, 16(1), 84–100.PubMedGoogle Scholar

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.University of Colorado-DenverDenverUSA
  2. 2.Private PracticeNew York CityUSA

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