Grounded Theory of Asian American Activists for #BlackLivesMatter

Stacey Diane Arañez Litam, Christian D. Chan

A grounded theory study was employed to identify the conditions contributing to the core phenomenon of Asian American activists (N = 25) mobilizing toward thick solidarity with the Black Lives Matter (BLM) movement in 2020. The findings indicate achieving a collective oppressed identity was necessary to mobilize in thick solidarity with the BLM movement and occurred because of causal conditions: (a) experiences of COVID-19–related anti-Asian discrimination, and (b) George Floyd’s murder. Non-action, performative or unhelpful action, and action toward thick solidarity were influenced by contextual factors: (a) alignment with personal and community values, (b) awareness and knowledge, and (c) perspectives of oppression. Mobilization was also influenced by intervening factors, which included affective responses, intergenerational conflict, conditioning of “privileges” afforded by White supremacy, and the presence of organized communities. Mental health professionals and social justice advocates can apply these findings to promote engagement in the community organizing efforts of Asian American and Pacific Islander communities with the BLM movement, denounce anti-Blackness, and uphold a culpability toward supporting the Black community.

Keywords: Asian American, solidarity, social justice, Black Lives Matter, grounded theory

 

Trayvon Martin’s death in 2012 reignited conversations about the underlying sentiments of White supremacy that remain deeply entrenched in American society (Khan-Cullors & Bandele, 2017; Taylor, 2016). Shortly thereafter, the #BlackLivesMatter (BLM) movement was launched to address acts of police brutality on Black and Brown people and challenge the systemic oppression within the justice system (Lebron, 2017). Following the murder of George Floyd in 2020, the role of silence in perpetuating complicity resurfaced, and the familiar narratives and gut-wrenching images of non-Black police officers harming Black bodies once again found a place in the limelight (Chang, 2020; Elias et al., 2021). However, this time there was something noticeably different; one of the non-Black officers was Asian American.

Tou Thao’s role in sanctioning George Floyd’s murder illuminated the complex history of anti-Blackness within Asian American and Pacific Islander (AAPI) communities; created momentum for conversations about race, discrimination, and oppression; and echoed earlier support for the BLM movement among AAPIs (J. Ho, 2021; Merseth, 2018; Tran et al., 2018). These discussions may have been traditionally avoided, given the narrative invoked by racial and colonial notions that diminishes critical consciousness about racial histories and relations in AAPI communities (Chang, 2020; David et al., 2019). Because of the structural conditions of White supremacy and colonialism, AAPI communities have been forced to adopt Whiteness as a pathway to success, minimize salient cultural values, and trivialize manifestations of anti-Blackness (J. Ho, 2021; Poon et al., 2016). Erasing critical consciousness among AAPI communities has served as an insidious attempt to maintain a racial hierarchy that neither supports AAPI visibility nor eradicates racial tensions (Chou & Feagin, 2016; David et al., 2019). The invisibility of AAPI history absolves the United States from long-standing histories of anti-Asian racial violence (Li & Nicholson, 2021) and endorses complacency of White supremacy (Museus, 2021; Poon et al., 2019). Although this contention exists, a greater number of AAPI voices have begun to mobilize in solidarity with the BLM movement and the Black community in recent years (Anand & Hsu, 2020; Lee et al., 2020; Merseth, 2018; Tran et al., 2018).

Despite a complex racialized history of White supremacists weaponizing communities of color against each other (Nicholson et al., 2020; Poon et al., 2016), AAPI individuals have a long-standing history of pursuing thick solidarity and activism with the Black community and supporting Black civil rights (J. Ho, 2021). These racial coalitions have been evidenced through the Third World Liberation Front Strikes and the tireless efforts of activists like Grace Lee Boggs, Yuri Kochiyama, and Richard Aoki (W. Liu, 2018; Sharma, 2018). Thick solidarity is achieved when racial differences are acknowledged while emphasizing the specificity, irreducibility, and incommensurability of racialized experiences (W. Liu, 2018). Although understanding the factors that influence AAPIs to mobilize with the Black community represents a critical step toward thick solidarity (Tran et al., 2018), previous studies investigating the phenomenon have been limited to quantitative methods (Merseth, 2018; Yoo et al., 2021) or focused solely on Southeast Asian American populations (Lee et al., 2020).

The following sections outline the histories of racialized oppression faced by Asian American and Black communities and provide a brief overview of the extant research linking Asian American solidarity with the BLM movement. A grounded theory that identifies the emergent process that contributed to Asian American activists mobilizing toward thick solidarity with the BLM movement in 2020 is additionally presented.

The Racialized Experiences of Asian Americans and Black Communities in America
Prior to engaging in a grounded theory, researchers must build upon preexisting processes, theories, and perspectives documented in extant research (Charmaz, 2017). Thus, one cannot explore the processes that contributed to Asian American activists mobilizing toward thick solidarity with the BLM movement in 2020 without first addressing the nuanced and racialized experiences of AAPI and Black communities in America. Tran et al. (2018) asserted that navigating an oppressive system embedded in White supremacy has forced communities of color to make historical adaptations that leave AAPI voices out of the BLM movement. The following section provides a brief description of the complexity in which AAPI and Black identities are juxtaposed and elaborates on the model minority myth, racial triangulation, and historical anti-Blackness in AAPI communities as processes that may complicate the process of achieving thick solidarity.

Racial Triangulation
According to Kim (1999), racial triangulation theory refers to a “field of racial positions” (p. 106) that was proposed to extend the conceptualization of racial discourse beyond the Black and White narrative. The field of racial positions is mapped onto two dimensions. The superior/inferior axis represents the process of relative valorization, whereby Whites valorize Asian Americans relative to Black Americans in ways that maintain White privilege and White supremacy (Kim, 1999). The second dimension, an insider/foreigner axis, refers to the process of civic ostracism, in which Whites position Asian Americans as foreign, unassimilable, and outsiders (Kim, 1999; Xu & Lee, 2013). Although Asian Americans may be afforded social and economic benefits due to their proximity to Whiteness, this social location functions as an incomplete portrayal that conceals inequities, treats Asian Americans as perpetual foreigners, and maintains the status of White supremacy over communities of color (Bonilla-Silva, 2004; Nicholson et al., 2020). As a result, members of Asian American communities may be racialized to be White-adjacent and create an illusion of success with a conditional set of privileges (Kim, 1999; Museus, 2021).

One example of racial triangulation is the model minority myth, which essentializes Asian Americans by portraying them as a monolithic group with universal educational and occupational success (Chou & Feagin, 2016; Yi et al., 2020). According to Poon et al. (2016), scholars must acknowledge the model minority myth’s history to challenge processes of racial triangulation and deficit thinking. The model minority myth creates barriers to social justice efforts and racial coalitions by pitting communities of color against one another (Chang, 2020), invalidating experiences of systemic oppression and discrimination (Nicholson et al., 2020; Pendakur & Pendakur, 2016), and maintaining “a global system of racial hierarchies and White supremacy” (Poon et al., 2016, p. 6). When contextualizing the model minority myth through the lens of critical race theory, Asian Americans may be conceptualized as a “middleman minority” (Poon et al., 2016, p. 5). Originally coined by Blalock (1967) and later expanded upon by Bonacich (1973), middleman minorities are foreigners who buffer the power struggles between two major groups in a host society. Similar to other historical middleman minority groups, the minority model myth exploits Asian Americans by granting economic privileges while denying political or social power (Poon et al., 2016). As a more egregious consequence, the model minority myth can lead communities of color to harbor feelings of resentment toward Asian American communities, especially Asian immigrants who may feel pressured to prove their loyalty to American values (J. Ho, 2021) and embrace the submissive, hardworking qualities espoused by the model minority myth (Poon et al., 2019).

The complex relationship between AAPI and Black communities becomes even more complex as communities of color, including Black Americans, continue to define the boundaries of inclusion about “who belongs in communities of Color” (Tran et al., 2018, p. 78). As a result, Asian Americans are rarely included in race dialogues; may not be identified as “of color” by other groups; and are forced to navigate their weaponized, conditional identities as racialized in some spaces and White-adjacent in others (C. D. Chan & Litam, 2021; Litam & Chan, 2021; Museus, 2021; Poon et al., 2016).

Understanding Anti-Blackness in Asian American Communities
The denigration of Black identities and the desire to be viewed as distinct from Black Americans are evidenced across the histories of several Asian American ethnic subgroups. For example, in the mid-20th century, access to U.S. citizenship was limited to free White persons and persons of African descent (Pavlenko, 2002). At the time, the system was not set up to accommodate Asian Americans or other racialized groups, as evidenced by the landmark cases of Takao Ozawa and Bhagat Singh Thind (Chou & Feagin, 2016; Haney López, 2006). After living in the United States for over 20 years and articulating his relationship to White racial groups because of his light skin, Takao Ozawa, a Japanese man, was judged to be a race other than those able to obtain citizenship and deemed ineligible for naturalization (S. Chan, 1991; Yamashita & Park, 1985). Bhagat Singh Thind, an Asian Indian man, attempted to align specifically with the use of “Caucasian” and White racial ideologies, but was also denied citizenship by the U.S. Supreme Court (Haney López, 2006). Following the United States v. Bagat Singh Thind ruling, nearly 50% of Asian Indian Americans had their U.S. citizenship revoked (Haney López, 2006). Despite attempts to prove their loyalty to Whiteness, both cases reified how Asian Americans are placed in a vexing situation that provides an illusion of privileges but excludes them from fully participating as U.S. citizens (Haney López, 2006; Nicholson et al., 2020). Both cases also exemplified early instances of Asian American individuals who were pressured by prevailing racial ideologies to eschew Blackness and assimilate into dominant norms of White supremacy.

Examples of anti-Black sentiments are deeply rooted in people of Filipino descent who may endorse colonial mentality, an internalized form of oppression characterized by a preference for Western attitudes and the denigration of Filipino culture following years of colonization by the United States (David & Okazaki, 2006a, 2006b). For example, internalized anti-Black sentiments in Filipino culture are evidenced by the systematic discrimination against the dark-skinned Ati people, who are indigenous to the Aklan region (Petrola et al., 2020). As a result of the mining, logging, and tourism industries, the Ati have been forced to relocate onto smaller plots of land, face physical violence, and are denied various human rights (Petrola et al., 2020). Other insidious anti-Black attitudes that permeate the Filipino worldview include White-centered beauty notions that venerate straight hair and light skin over textured locks and dark skin (Nadal, 2021; Rafael, 2000). Despite their documented toxic and dangerous consequences, skin whitening products in the Philippines are a billion-dollar industry (Mendoza, 2014). These examples relay cultural and economic implications that are predicated on histories of global imperialism and colonialism, which root out indigeneity in favor of Eurocentric values and White norms (Fanon, 1952). Examples of anti-Black sentiments in Filipino communities are a sample of the ways in which colonialist movements mapped anti-Blackness onto Filipino communities and culture by occupation of the land, terrorism, and brutality (David, 2013; Nadal, 2021).

History of anti-Black attitudes may also exist in Korean Americans following the 1992 Los Angeles riots. After White officers were exonerated in the beating of Rodney King and a Korean store owner fatally shot 15-year-old Latasha Harlins, tension erupted between the Black and Korean American communities due to the lack of accountability for the killing of a Black person. Media reports of widespread rioting, theft, injuries, and damage to businesses were attributed to poor race relations between African American and Korean communities and larger issues of systemic racism were disregarded (Oh, 2010; Sharma, 2018). Despite calls to law enforcement for help, Korean voices were overlooked by the police (Yoon, 1997), which potentially illustrates how the law enforcement system reacts in favor of White interests. Once again, White media highlighted the undercurrent of racial tension between ethnic and racial groups as noteworthy and masked preexisting racial coalitions between Black and Asian American communities. These news stories deterred Asian American and Black communities from looking outward and acknowledging the larger issues of ongoing police brutality and inequitable justice systems (F. Ho & Mullen, 2008).

Chinese Americans may harbor anti-Black notions following the conviction of Peter Liang, who fatally shot Akai Gurley in New York City (W. Liu, 2018). Although he was the first officer indicted for killing an unarmed and innocent Black man, Liang’s conviction resulted in conflict between Chinese American and Black American communities (R. Liu & Shange, 2018; W. Liu, 2018). Many individuals within Asian American communities argued for the fair sentencing and punishment of Liang (Tran et al., 2018), but others protested the charge and believed the courts used him as a scapegoat to detract from BLM activists who called for police reform (R. Liu & Shange, 2018; W. Liu, 2018).

Challenging Historical Anti-Blackness in Asian American Communities
Challenging anti-Blackness in Asian American communities underscores a cultural paradox. On one hand, Asian American individuals, especially East Asian subgroups, benefit from social and economic privileges because of their proximity to Whiteness and identities as non-Black minorities (Bonilla-Silva, 2018; Poon et al., 2016). Thus, some Asian American individuals endorse aspects of the model minority myth because of the privilege it affords (Kim, 1999), even at the expense of maintaining a racially triangulated identity (Bonilla-Silva, 2004; Poon et al., 2019; Yi et al., 2020). Anti-Blackness therefore moves beyond prejudicial attitudes against Blacks and encompasses a performance of Whiteness (W. Liu, 2018).

Movements initiated by younger Asian American generations that challenge anti-Black sentiments (e.g., #Asians4BlackLives) are gaining traction (Anand & Hsu, 2020; Lee et al., 2020) and can help Asian immigrants move beyond their own unacknowledged pain and racial trauma to appreciate the challenges of other marginalized communities (David et al., 2019; Tran et al., 2018). For example, Letters for Black Lives is a crowdsourcing project that empowers communities of color to have conversations about anti-Blackness with older generations (R. Liu & Shange, 2018) who may endorse anti-Black attitudes following injustices against Asian people (e.g., Peter Liang) or anti-Asian historical events (e.g., the LA riots). These letters help younger Asian American communities describe ambiguous and complex issues related to social justice, racism, and systemic oppression with their families and have been helpful in promoting support for the BLM movement (Arora & Stout, 2019).

Extant Research on Racial Coalitions

Extant research posits how experiences of ingroup discrimination cultivate increased empathy, positive attitudes, and a collective sense of community (Craig & Richeson, 2012; Tajfel & Turner, 1979). As rates of anti-Asian discrimination have substantially increased following the COVID-19 pandemic and negatively affected the psychological well-being of Asian American communities (C. D. Chan & Litam, 2021; Jeung & Nham, 2020; Litam, 2020; Litam & Oh, 2020, 2021; Litam et al., 2021), the Common Ingroup Identity Model (CIIM; Gaertner & Dovidio, 2000) may help explain the increasing number of Asian American voices in support of BLM. According to the CIIM, experiences of racial discrimination toward one’s own racial group may lead to a shared disadvantaged racial minority identity that engenders positive attitudes and feelings of closeness toward other racial minorities. Compared to White, male, high-status groups, racialized minorities (e.g., Asian Americans) may be more likely to experience feelings of solidarity and affiliation with other communities of color believed to share experiences of racial discrimination (Brewer, 2000; Gaertner & Dovidio, 2000).

Preliminary support for the CIIM may be evidenced by a quantitative study conducted by Merseth (2018). Using a nationally representative sample of data, Merseth determined AAPIs who supported BLM were more likely to perceive anti-Black discrimination in the United States and identify race-based linked fates. A recent ethnography that examined AAPI support for the BLM movement identified the importance of community-based educational spaces as paramount to engaging in antiracist work and cultivating cross-racial coalitions among Southeast Asian Americans (Lee et al., 2020). Lee and colleagues’ (2020) results illuminated the importance of educational institutions that provide the foundation and language needed to challenge anti-Blackness among Southeast Asian communities. Combined with these studies, a more recent investigation by Yoo et al. (2021) involved a quantitative measurement of racial groups and their support for the BLM movement. Although this crucial study revealed the implications of solidarity among several racial groups with the BLM movement, the Yoo et al. study only involved a convenience sample of college students and did not necessarily account for the nuances within participants’ social identities, their motivations for support, or historical and political contexts. In the context of increased anti-Asian racial discrimination in the wake of COVID-19, shared experiences of anti-Asian discrimination may result in “a common ground of solidarity that Asian Americans and African Americans can forge against White supremacy” (Anand & Hsu, 2020, p. 194).

Purpose of the Present Study
The centralization of police brutality on Black and Brown people has reignited conversations about systemic oppression and has illuminated the need for civil rights, racial equity, and the dismantling of White supremacy (Elias et al., 2021; R. Liu & Shange, 2018; W. Liu, 2018; Tran et al., 2018). Although AAPIs may face discrimination in the wake of COVID-19 in ways that may result in solidarity with the BLM movement (Chang, 2020; J. Ho, 2021), a qualitative study that underscores this process with diverse Asian American voices can further contextualize meaningful opportunities for racial coalitions. Given the historical presence of anti-Blackness in Asian American communities (W. Liu, 2018; Tran et al., 2018), generating an emergent process that outlines the path of Asian American activists mobilizing toward thick solidarity with the BLM movement is of paramount importance to continue bolstering efforts toward racial coalitions (Lee et al., 2020; Merseth, 2018). To address the paucity of literature, a grounded theory was conducted to examine the following research question: What is the process that mobilizes Asian American activists to pursue thick solidarity with the BLM movement in 2020?

Method

Qualitative methods are appropriate when researchers seek to develop a complex or detailed understanding of an experience (Creswell & Poth, 2018). Specifically, grounded theory is a qualitative method used to generate a theory grounded in the data from participants who have experienced the process under inquiry and focuses on maximizing numerous perspectives constructed over phases of time (Charmaz, 2017). Given our desire to understand the process of action through which Asian American activists mobilize toward thick solidarity with the BLM movement, a grounded theory approach was deemed appropriate. To this end, the grounded theory focused on what participants experience and how the process of mobilizing in solidarity for BLM unfolds.

This study was implemented using a social constructionist paradigm to complement Charmaz’s (2014) constructivist grounded theory. Social constructionist researchers recognize the presence of multiple, processual, and constructed realities while acknowledging the role and importance of the researchers’ and participants’ positionality (Charmaz, 2014; Clarke, 2012). Social constructionism augments three overarching themes: (a) critiquing the neutrality of participants’ and researchers’ values by locating perspectives within social contexts (e.g., time, culture); (b) revealing language as a vehicle for shaping representation within particular communities; and (c) introducing different perspectives to unsettle social conditions and co-create new knowledge (K. J. Gergen, 2020; M. Gergen, 2020).

Procedure and Participants
Internal Review Board approval was obtained before beginning the study. Participants in this study were selected through the use of purposive and theoretical sampling (Timonen et al., 2018). The first and second authors, Stacey Diane Arañez Litam and Christian D. Chan, used purposive sampling to disseminate recruitment materials to key social media groups and community networks focused on AAPI community organizing. In the initial stages, Litam interviewed the first group of participants and ascertained their social identities. Next, theoretical sampling was employed. To introduce additional perspectives after the first group, Litam focused on soliciting more participants to expand the sample based on region, gender, and ethnic identities. Prospective participants could participate if they (a) self-identified as a member of the Asian American community and (b) identified as being engaged in ongoing support of the BLM movement. Prospective participants were recruited by posting on social media pages frequented by Asian American individuals actively involved in BLM activism. Prospective participants were asked to email Litam and were given more information describing the study’s purpose, design, and research questions. Eligible participants were informed that participation was voluntary, the research would not directly benefit them, and no compensation would be offered. A consent form was completed before participation occurred. Interviews were held on a HIPAA-compliant Zoom account.

This study consisted of interviews with 25 AAPI individuals who were actively engaged with the BLM movement. To protect confidentiality, participants were given pseudonyms. Participants reported a diversity of identities that increased the heterogeneity of the sample. Participants’ ages ranged from 25 to 73, and ethnic identities of participants included Filipino (n = 10), Korean (n = 5), Chinese (n = 2), Japanese (n = 1), Vietnamese (n = 1), Chamorro (n = 1), and multiracial (n = 5) descent. The gender identities of participants included women (n = 17), men (n = 5), and non-binary (n = 3). Most participants reported being a U.S. citizen and one participant identified as Canadian. Four participants identified as transracial adoptees.

Data Collection
Data collection occurred between June and July 2020. Semi-structured interviews lasted an average of 90 minutes. Participants responded to the following questions: (a) What are your experiences regarding how Asian Americans have historically supported, or are currently supporting, the Black Lives Matter movement? (b) Which contexts or situations have influenced your desire to support the Black Lives Matter movement? and (c) Which contributing factors influenced your development toward a social justice–oriented mindset? Follow-up questions developed organically. Participants provided consent for the interview to be recorded and were informed they could end the recording or the interview at any time. Only the audio file of the interview was saved, and the file was not uploaded to any cloud-based servers so as to promote participant confidentiality. Litam transcribed all interviews. Following the interview, participants completed two 15-minute member-check meetings—first to confirm the accuracy of researchers’ themes, and second to reflect on the final grounded theory.

Throughout the interview, Litam restated the major points after each response. Clarification was obtained through follow-up questions when participants described new concepts that had not been described by previous participants. Litam did not move onto the next question until each of the major points described by the participant were accurately identified and reflected. At the end of the interview, Litam summarized the conversation and restated the major points to confirm understanding of the participants’ statements. Follow-up questions, member checks, restatements, analytic memo writing, and constant comparative method were used to analyze the data.

Data Analysis
The data collection and analysis process reflected a concurrent process and a recursive process, which informed one another and led to the development of an emerging grounded theory (Charmaz, 2017). Throughout the data analysis process, concurrent analytic techniques of induction, deduction, and verification were used to develop an emergent theory (Charmaz, 2014). Litam immersed herself in the raw data by transcribing, reading, and listening to the audio transcripts. Transcription was completed within 24 hours of the interview, and member checks with participants to confirm themes were completed within 72 hours of the interview. New data were compared to existing data following the completion of each transcribed interview. Initial codes and analytic memos were used throughout the process to create an audit trail. Data were closely examined for disconfirming evidence, and two external auditors were used throughout the data analysis process to understand how our assumptions could influence the coding and findings.

Two external auditors were used between open and focused coding to confirm emergent findings, discuss the accuracy of emerging themes, and triangulate across perspectives (Saldaña, 2021). Both external auditors identified as members of the AAPI community and endorsed a strong commitment to AAPI concerns, research, and mental health. The second external auditor also carried in-depth training in qualitative methodologies. Data were coded with labels that categorized, summarized, or accounted for each piece of data (Charmaz, 2014; Saldaña, 2021) and analytic memos were used to help scrutinize the data (Miles et al., 2020). Each participant confirmed the accuracy of themes and reported feeling energized by the theory, a phenomenon known as catalytic validity (Guba & Lincoln, 1989).

We engaged in reflective commentary throughout the interview and data analysis process by using bracketing and ongoing evaluation. Peer scrutiny was employed by inviting three AAPI colleagues who were familiar with the phenomenon to offer feedback and fresh perspectives on the findings as they continued to emerge and become saturated. The first colleague identifies as a transnational Chinese woman and is an associate professor. The second colleague identifies as a Chinese woman who specializes in counseling AAPI communities. The third colleague identifies as a Filipino, Chinese, and Malaysian man and works as a counselor educator. Interviews were conducted until saturation occurred and fresh data no longer sparked new theoretical insights or properties of the generated grounded theory, its categories, or its concepts.

Researcher Reflexivity
A researcher’s social location, biases, theoretical lens, and epistemological beliefs must be established to increase the trustworthiness of results (Saldaña, 2021). Litam identifies as a foreign-born Filipina and Chinese American woman. She is a counselor educator, an assistant professor, and a licensed professional clinical counselor and a supervisor. She conducts research on topics related to human sexuality, human trafficking, trauma, race, diversity, and AAPI issues. Litam has overcome her own internalized colonial mentality as a Filipina American woman and endorses a strong commitment toward issues of social justice and racial equity. She is dedicated to engaging in work that dismantles the forces of White supremacy that oppress all racialized groups.

Chan is a queer person of color and a second-generation Asian American of Filipino, Chinese, and Malaysian heritage. As an assistant professor, he invests primarily in scholarship on intersectionality, social justice, activism, multiculturalism, career development, and communication of culture and socialization in couple, family, and group modalities. He actively works toward racial coalitions that interrogate structures of White supremacy and organizes intentional community initiatives for solidarity. Many of his perspectives, especially toward the inquiry at hand, attend to social structures and histories that underpin ideologies of White supremacy.

Trustworthiness
Grounded theory requires standards of quality and trustworthiness, including credibility, originality, resonance, and usefulness (Charmaz, 2014; Creswell & Poth, 2018). To promote trustworthiness, constant comparison was employed by using open codes, a codebook, and data to inform, analyze, and compare new data sources (Charmaz, 2014). Any new data were consistently checked and compared to the emerging theory. Member checks were completed twice by connecting with participants over Zoom for approximately 15 minutes each. We also used peer scrutiny with three AAPI colleagues and two AAPI external auditors to challenge assumptions and biases, triangulate findings, and engage in dialogue about clusters of meaning and themes as they emerged. These strategies were used to ensure the theory was data-driven rather than reflective of our own beliefs, values, and assumptions (Hays & Singh, 2012). Analytic memos were written after each round of coding, which elaborated emotions, thoughts, and personal reactions to the data. This information strengthened the tracking of the data and our influence as we shared the audit trail with both external auditors. Thus, multiple measures of trustworthiness were used to account for positionality that could influence the data and theory development.

Findings

We sought to examine the following research question: What is the process that mobilizes Asian American activists to pursue thick solidarity with the BLM movement in 2020? The results of the grounded theory analysis describe the process through which causal conditions, contextual factors, and intervening conditions affect actions and foster pathways to consequences following the core category of the phenomena of interest (see Figure 1).

Figure 1

Grounded Theory Outlining AAPI Process of Mobilizing in Thick Solidarity With BLM in 2020

 

Causal Conditions
Based on perspectives from participants, two causal conditions led participants to mobilize toward solidarity for BLM in 2020.

George Floyd’s Murder
Exposure to George Floyd’s murder through social media and news outlets was the first causal condition. For each of the participants, this event represented the “breaking point,” “threshold,” “spark,” or “tipping point” that illuminated the need to “act,” “pursue justice,” “make change,” and “fight back.” As stated by Gemma, a Filipina woman in her mid-30s:

When George Floyd died . . . I just refused to be silent about what happened to him. I just kept thinking, well, what the hell have I been doing that it didn’t impact enough change [so] that this man could have lived? This man died because we have not done enough. He died calling out for his mom. What I could not handle was if I had been born with a particular fear, and I died that way. This man was born and lived knowing that he could be murdered by the police. And that’s how he died. I refuse that. And I am personally responsible that the narrative has not changed in this country. I am responsible and I hold my communities responsible. We have not done enough so that man could have lived.

Experiences of COVID-19–Related Anti-Asian Discrimination
The second causal condition was identified as experiences of COVID-19–related anti-Asian discrimination. This condition was characterized by witnessing or experiencing broad anti-Asian discrimination and exposure to “Trump’s Anti-Chinese,” “xenophobic,” and “racist messages.” Participants described how anti-Asian rhetoric touted by political leaders and experiences of anti-Asian discrimination served as “tinder” that “incited,” “enraged,” and “irritated” AAPIs in ways that “primed” them to act.

For each of the participants, witnessing and/or experiencing COVID-19–related racism was an event that led to action. Each of the 25 participants stated that exposure to anti-Asian discrimination cultivated empathy for Black Americans and illuminated how their shared experiences of racial discrimination “opened their eyes,” “woke them up,” or “pulled off the blindfold” of their racialized identity as Asian Americans. Yuri, a Chinese and Vietnamese woman in her early 30s, explained:

We have this fresh memory of discrimination in the back of our heads, and you know, it reaches a boiling point. You have the intersection of your own experiences and somebody else’s experiences and you start to connect the dots that we are not so different. And we are not so safe. We have more in common with Black lives than we do with White ones.

These sentiments were echoed by Hunter, a Korean man in his early 50s:

The pandemic created this anti-Asian reality. It really brought attention to the average Asian American [about] how much anti-Asian sentiment is still out there. You know, we all live in our little bubbles in life. And we don’t really see what’s going on. But I think, you know, seeing all these news stories about anti-Asian violence, whether we are members of the older generation reading our ethnic papers or just, you know, a member of the younger generation watching television, we see this stuff on the news and it has kind of served as the kindling to the fire to act and do more.

Evelyn, a Filipina woman in her early 40s, also described how exposure to anti-Asian rhetoric touted by political leaders primed her to act:

This particular president [Trump] is stoking the flames [and] it’s re-energizing a particular base of people who are emboldened to say and do things that are hate-centered, that are violent, that are wrong. And I think that it also touched on a particular powerlessness that Asian Americans have felt. And when you couple that within a global pandemic you are hyper aware of your mortality. You could die from this virus that’s going around, [and] we are all wearing masks. You couldn’t get more on edge, you know? We were primed to act. We were ready.

Josie, a multiracial woman in her mid-30s, explained:

Yes, we’re being harassed. We’re being called names. We’re experiencing another wave of xenophobia and racism, being told to go back to our countries, being told that we are not welcome here. I believe that Asians are saying, “Okay, yeah, we’re being threatened, but we’re not being held to the ground and choked out to the point that we’re being killed on TV.” I believe it’s awakened a lot of levels of pain and solidarity because you can’t imagine it. People can’t imagine that the world is this bad until someone’s last breaths are on TV. I think it mobilized people to become more involved because injustice does not have a place among any minority group. Injustice resonates with the Brown community, the Latinx community, the Asian community, and I believe it empowered us to move toward human empathy. Asians are realizing that if we don’t stand together, we stand alone, and nothing in this world will change.

Contextual Factors
Contextual factors were the individual traits and characteristics that affected the actions taken by participants to pursue mobilization in solidarity with BLM. Participants described three contextual factors: (a) alignment with personal and community values, (b) awareness and knowledge, and (c) perspectives of oppression.

Alignment With Personal and Community Values
The first contextual factor was defined as alignment with personal and community values. Notions of values alignment were identified in interviews when participants described how supporting the BLM movement was not a choice; rather, “protesting,” “supporting,” “fighting,” and “engaging in human rights activism” represented “values,” “moral imperatives,” and “needs.” Each of the participants described how mobilizing toward thick solidarity with the Black community reflected the direct consequence of one’s own set of values. Hunter shared the following: “Regardless of how it benefits the Asian American community, for me, it’s my sense of value. This is my own value system. I don’t feel comfortable having groups that are continuing to be oppressed.”

For some participants, notions of values alignment and the need to act had been socialized and were shared by their families of origin. José, a Filipino man in his early 30s, indicated:

I needed to act, there was no other choice. My parents taught me years ago how this whole [BLM] movement creates an obligation to speak up when injustice occurs. Our [Filipino] history has led us to learn that we always have been stronger when we all unite together because there is so much divisiveness in our society.

Evelyn described how values alignment represented a moral imperative:

For about 17 years, I have been an activist. I have always known at a very deep, personal, soul level, that issues of race are the knife on the throat of this country. This country has not resolved or has even come close to reconciling its history. And I don’t think that it [supporting BLM] was something that I decided. It wasn’t a neuron movement. It wasn’t a shift; it wasn’t something that physiologically or intellectually or cognitively shifted. It was like something else just shed, like a skin was pulled off me. It was just so plainly obvious that it was more than overdue for people to say something. We needed to act. There was no other option. It was just this plain, visceral refusal to be silent.

Participants described how alignment with personal and community values emerged because other Asian countries have been historically oppressed. Specifically, Hong Kong, Vietnam, and the Philippines were identified as countries that “silenced Asian voices” in ways that amplified participants’ desire to underscore their values in the United States. Byron, a Vietnamese and Chinese man in his late 30s, identified the following perspective on contextual factors:

I think it’s very important for us, as Asian Americans or even Asians across the world, to really be vocal on this [BLM movement]. Because, dude, America is a crazy place. It’s a beautiful country, but at the same time, the system is kind of jacked, right? And, you know, my parents being from Vietnam and really trying to get away from communists and stuff, I see what the Hong Kong people are going through right now. That to me is like a sign. Like, their battle is different from ours, but it’s still the same. We need to fight for what’s right.

Awareness and Knowledge
The second contextual factor was identified as awareness of one’s identity as a person of color and knowledge of how all communities of color are affected by systemic racism and White supremacy. Participants described how learning about Asian American history and the impact of racial triangulation, how AAPI liberation is directly tied to Black liberation, and the weaponization of the model minority myth were critical factors that contributed to their BLM activism. Rufio, a Filipino man in his late 20s, recalled the following memory:

Peter Liang, I think, was the first person that got convicted of anything. I clearly remember a street. On one side of it were Black protesters and on the other side were Asian American protesters. One side was saying, “Peter was innocent!” and the other side was like, “He deserves more of a sentence!” African American and Asian American protesters were pointing at each other when really they should have been looking outside [of] the situation and being like, the people in power set this game up so we didn’t look at them. They were making us look at each other, but we shouldn’t be looking at each other. We should be looking at them.

Participants identified the importance of achieving multiracial unity and described how the fates of communities of color are inextricably linked. Jay, a non-binary Filipinx person in their early 20s, asserted the following about multiracial unity:

When we center the most vulnerable or the most marginalized, then we are able to lift up everyone. And I think that’s why a lot of people are focusing on the term BIPOC and [are] like, trying to center Black people and Indigenous people, because Black people have been enslaved and Indigenous people [have] had so many atrocities committed to them on stolen land. Ultimately, we are all in this together and what we do for one affects us all.

Similarly, Dante, a transracially adopted Taiwanese man in his mid-20s, observed the political implications surrounding race relations in the United States:

Honestly, I think that four years of the Trump presidency is probably a big mobilizing factor. His policy towards China has been just straight-up racist on his best days and, you know, far worse on his bad days. And so one of the concerns that I had is like, he has no problem locking up kids and immigrants in detention centers. At what point is that going to start being directed at Asian people? If we don’t fight for other people of color, who’s going to fight for us when it is our turn?

Jubilee, a Chinese woman in her early 30s, described the recent AAPI support of BLM and emphasized the importance of cultivating awareness and knowledge with her community and family of origin:

I feel like this is the first time I’ve seen such solidarity from Asians to the Black community. It happened back in the 60s during the civil rights movement so like, we are not the first, but like, in my generation and in my lifetime, this is the first time I am seeing that from us as an Asian community. There are finally conversations coming up about anti-Blackness in Asian communities, you know? It has also allowed me and my brother to bring up these conversations and issues with our friends and parents. For the first time in our lives, we are having conversations about anti-Blackness and systemic racism, and they are not brushing it off. They [my friends and parents] actually take a pause and listen, and this was the first time seeing them do that. And that’s pretty cool. There’s still a long way to go, but there is definitely some change happening. I see it and I feel it around me.

Perspectives of Oppression
Participants conceptualized their experiences from two distinct perspectives of oppression that uniquely influenced the strategies used to mobilize in thick solidarity toward the BLM movement: (a) as a member of the AAPI community or (b) as a member of a greater community of minoritized groups. Participants who limited their perspective of oppression to the AAPI community tended to center Asian voices in support of the BLM movement (i.e., “Yellow Peril for BLM”). Participants in the first category tended to limit their focus to how supporting the BLM movement would benefit the Asian community. Byron explained how supporting the BLM movement better positions the greater Asian American community to engage in advocacy:

I think us mobilizing together and supporting the Black Lives movement would really help us out as a community. Not only as just Chinese, Vietnamese, and Filipino and all that, but literally, as one Asian community. I think we are learning from the Black Lives movement. Not only are we participating with them, but it’s almost like training wheels for our community to be like, we need to be louder about certain rights that we want or certain things that we want to talk about. The United States has created the perfect platform for us to express that, and we have not utilized that.

Conversely, participants who endorsed a wider perspective that recognized Asian Americans as members of one oppressed minoritized group centered the Black community and amplified Black voices. Participants in the second category were more likely to recognize how mobilizing in thick solidarity with the BLM movement would benefit the larger constellation of communities of color. June, a Korean, non-binary, transracially adopted person in their late 20s, highlighted this connection across social movements:

So many Asian people don’t want to post about anti-Asian oppression alongside Black Lives Matter. They are like, “Oh I don’t want to take away from the Black Lives Matter movement by posting about the racism that I experienced or by posting about immigration.” But I kind of see them as being connected because we all face the same oppressor. We are all dealing with White supremacy, so we need to realize all of our movements are interconnected. We need to be in solidarity with each other.

Mia, a Korean woman in her early 30s, similarly explained this relationship:

Just like how we wonder, How is discrimination affecting the greater Asian community?, I think you have to extend that exercise to, How is it affecting the Black community? Where is it [discrimination] starting from? Whose lives are affected? Instead of just being like, “These are the discrimination experiences I face in my life,” it becomes a bigger conversation about what our greater community of minorities faces.

Intervening Conditions
Intervening conditions represent the broad and general factors that influence strategies based upon action or inaction and may include time, space, culture, history, emotions, and institutions. In this study, Asian American participants described four intervening conditions that either facilitated or created barriers to mobilizing toward thick solidarity with the BLM movement. Intervening conditions were described as having a bidirectional nature with the contextual conditions and action strategies used by participants.

Affective Responses
Participants described how feelings of “fear,” “anger,” “helplessness,” “empathy,” and “compassion” intersected with George Floyd’s murder, experiences of COVID-19–related anti-Asian discrimination, alignment with personal and community values, awareness and knowledge, and perspectives of oppression. Nearly every participant identified how they had “struggled” with, “overcome,” or “witnessed” how Asian Americans become paralyzed by fears of “taking up space,” “being too privileged,” or “not sharing the same intensity of oppression as Black Americans.” June described how some AAPIs become too overwhelmed by their privilege to engage in activism:

I so often hear them [AAPIs] say, “I want to help, but I can’t do anything. I can’t, I can’t. I don’t feel it’s in my place because I’m not Black. I feel like my voice doesn’t matter in this situation because I don’t suffer in the way that they [Black Americans] do.” I’ve seen so many excuses about how their voices are too privileged to matter, and it’s not true.

Annie, a Vietnamese woman in her early 30s, explained how fear can limit action:

They [AAPIs] fear that if they stand with the Black community, they will be ousted, attacked, treated differently, and looked down upon. I’ve seen a lot of fears that family would disown them if they become more vocal about Black Lives Matter because the older generation is very stuck in their own mindset of teaching the younger generations, you know, “You keep your head down, you go to school, you make a life for yourself, you don’t make waves, because it will only ruin your life.” I’ve seen a lot of people say that they can’t be as vocal because they are only one person.

Intergenerational Conflict
Participants identified intergenerational conflict as the second intervening condition that influenced Asian American action or inaction. Each participant described how Asian Americans and Asian immigrants (especially older individuals) lacked social justice–oriented language and stressed the importance of assimilation, and how those influences affected the shifting realities between first-generation Asian Americans and subsequent generations in their support of the BLM movement. Conversely, Asian Americans who were willing to engage in discussions about racial discrimination and cultivate cross-racial relationships were more likely to mobilize toward thick solidarity with the BLM movement. Participants also described how older Asian Americans and Asian immigrants struggled to grasp the “cultural nuances” that contextualize the history of systemic oppression and police brutality on Black and Brown individuals in America. The cultural barriers for many older Asian immigrants were described by Lin, a transracially adopted Korean woman in her early 30s:

The social justice language that we use when it comes to Black Lives Matter is difficult enough for a White person who is unfamiliar with this terminology. [It’s hard] to try and communicate that across generational lines, especially because a lot of us don’t have the strength in language skills to be able to translate. From what I’ve observed in my parents, they’ve kind of just kept their head down. They stressed assimilation very strongly for their children. It’s that old-school, “don’t rock the boat” mentality. Don’t give them a reason to look at us. Don’t give them a reason to hate us, you know? Don’t do anything to jeopardize this freedom that they worked so hard to achieve [and] that we’re so lucky to have.

Participants also described how first-generation Asian American and Asian immigrants were more likely to be “encapsulated,” “avoid other racial groups,” and “keep to themselves” in ways that prevented the cultivation of meaningful cross-racial relationships and kept them from challenging historical anti-Black sentiments. The importance of connecting with other communities of color to foster empathy and challenge historical anti-Blackness among Asian Americans and Asian immigrants was described by Ira, a multiracial woman in her early 70s:

I think that when older Asians are exposed in even a small way to the African American community, they can understand. But many Asian people stay within people of their own color, and they stay within their own ethnicity and they stay within their own groups. If you stay in your own community and you never see an African American person except [for] what you see on TV, it’s hard to see the similarities and realize that we are not so different.

To complement this notion, Jenny, a multiracial woman in her early 40s, discussed this perspective:

I feel like it’s really common for Asian immigrants not to connect with these situations [of discrimination] that are happening to them, either in individual instances or in bigger systems. They’re not tying them back to racism. I think that for so long, you know, immigrants were just trying to survive. First-generation folks were just trying to keep their head down, stay out of trouble, and survive, and they couldn’t get distracted by thinking about what else was happening around them.

Conditioning of “Privileges” Afforded by White Supremacy
The third intervening condition was coded when participants described how being Asian American represented “conditional,” “unsafe,” and “hyphenated” identities and when proximity to Whiteness elicited confusion about their role in activism. For some participants, the conditioning of “privileges” afforded by White supremacy contributed to action. As described by Evelyn, Whiteness elucidated a system of different racialized experiences:

I begin to wonder how powerful is Whiteness, you know? If I’m not the one being killed in the street, but I’m also experiencing racism, where do I fit into all of this? You begin to question how Asian Americans have been inserted into this narrative. And for me, you begin to wonder like, am I a pawn in this? What is my level of responsibility here? Is there a shared oppression? Yes. Are we all tethered the same way? No.

Participants who struggled to overcome the conditioning of privileges afforded by White supremacy were more likely to vacillate between action and inaction. Monica, a transracially adopted Korean woman in her early 30s, stated the following:

I do feel like for Asians, you’re in this really interesting space. I do actually think I have a lot of privilege. And with that, potentially, some responsibility as a person that essentially has a long-standing visa or passport into Whiteness. I know the language. I know how White people think and act. I feel like I can talk to White people about racism in a way that other people don’t necessarily have access to. But also, I experience racism and I’m also really tired.

Organized Communities
The presence of social media groups; local, regional, national, and international groups; participants’ own Asian American communities; and other communities with shared group identities (e.g., the lesbian, gay, bisexual, and transgender [LGBT] community) were identified by participants as the fourth intervening condition. When organized communities were present, they either hindered or fostered mobilization. Participants who had communities that hindered mobilization described how their families and Asian American communities socialized them “not to rock the boat,” raised them to “keep their head down,” and discouraged “making waves.” Participants who lacked the presence of organized communities described feeling “burned out,” “alone,” and “unsupported.” As reported by Andi, a non-binary Korean person in their late 20s:

I have been fighting alone for years and it’s exhausting. I carry on because our activism is important, but it would be so nice to be able to meet up with other groups, share our experiences, and fill our validation cups, you know? It’s like, there is only so much I can do alone, and I don’t have the support I need to really keep going.

Participants described how communities fostered mobilization by providing the language, structure, resources, validation, and space necessary to begin talking about race and understanding the plight of other communities of color. Communities that fostered mobilization were most frequently described as college and university settings. Jackie, a Chinese and Japanese student in her mid-20s, described how her Asian American community on the university campus fosters action:

I just didn’t want to be by myself and protest alone. It feels good to learn more about why we are doing this and why it is important. Now, I felt like I have learned why it was so important that we as a group are able to rally behind the Black Lives Matter movement. I think community plays a huge part in supporting the BLM movement. It’s not just enough for us as individuals to be moving forward, it’s important that we have an Asian community presence in this battle.

The fostering role of communities in promoting thick solidarity was further described by Trichelle, a Chamorro woman in her late 50s:

I think the college and university experience has helped facilitate an understanding about race, generally, and experiences as Asian Americans or Pacific Islanders, secondarily. They facilitated an ability to see the connections, both the differences and the similarities of how racism has impacted AAPI communities but also how it is linked to the experiences of Black folks. The ability to have the language and to have some kind of infrastructure is critical to mobilize. Mobilization does not happen in the absence of some kind of organizational infrastructure.

Actions
To understand this larger process of action, participants in this study described non-action, performative action, or action toward thick solidarity. Participants additionally described how contextual factors, causal conditions, and intervening conditions interacted to influence the type of actions that occurred.

Non-Action
Non-action occurred when Asian American individuals were unable to challenge collectivistic notions of “not rocking the boat,” “not making waves,” and “not causing trouble.” Non-action was also more likely to occur when Asian Americans became overwhelmed by the economic and social privilege afforded to them because of their proximity to Whiteness. Upon considering the distinctness of Black oppression, participants described recognition of how Asian Americans may feel “unable,” “unsupported,” “guilty,” or “ineffective” to engage in action because of burnout; lack of community, validation, support, or resources; or feelings of “privilege guilt.” Participants also described how non-action may occur in older generations and Asian immigrants who may have internalized model minority traits, emphasized the importance of assimilation, remained encapsulated within the Asian American community, or lacked an understanding of systemic racism and social justice language.

Performative or Unhelpful Action
Performative or unhelpful action occurred when Asian American individuals either felt compelled to act to avoid being perceived as anti-Black or because supporting the BLM movement was “trending.” Unhelpful action occurred when Asian American individuals centered their issues in ways that disenfranchised Black issues or centered AAPI voices over Black voices (i.e., Asians4BlackLives). June described an example of how Asian American individuals may engage in performative action: “They’ll say one or two things online, and they’ll be like, ‛Oh, I did my part. I posted #BlackLivesMatter. Look at my profile picture. Look at my Instagram. Look, I posted a couple links for donations.’”

They also explained how centering AAPI voices constituted unhelpful action:

When someone posts “Yellow Peril Stands for Black Lives,” you’re actually overshadowing Black Lives Matter. Taking our title, our movement, and placing it in front of BLM says, “Hey, we’re here. We’re standing with you. Look at us.” That’s not acting in solidarity. It becomes one group saying, “I AM HERE. Here’s my voice for your voice.” We need to make our voices strong for theirs. We are the chorus and they are the lead singers.

Action Toward Thick Solidarity
Action toward thick solidarity occurred when Asian American individuals were able to support the BLM movement without centering AAPI issues or focusing on their own racial trauma histories. Demonstrating a willingness to learn how to be an ally and cultivating cultural humility were effective strategies in transcending action from performative or unhelpful to action toward thick solidarity. Sari, a Chinese and Lebanese woman in her early 30s, described the process of acting toward solidarity and the importance of communities that foster mobilization:

Solidarity to me is not a noun. It is a process that you continue to refine and reflect on and add or subtract things to, and it has a lot to do with your perspective and your approach. And I think a lot of solidarity with others comes from a genuine dedication to building your own community. I think a really important piece of solidarity is that introspection and community building with your own ingroup.

José explained how acting toward thick solidarity requires Asian Americans to follow the lead of Black activists. He tells the following story of how he explained allyship to a friend:

Remember two summers ago when you asked me to help you fix your deck, and I never knew how to work with power tools? The weekend before, I went on the internet and learned basic skills like how to hold a tool and how to be safe. And then when I went to your house, I wore a hard hat. I had everything ready, and I followed your lead and your leadership. That’s how you become an ally. You educate yourself. And when you go to situations you don’t center yourself. You follow the person who has the most experience.

Phenomenon, Consequences, and Core Category
Participants in the study described the process of feeling “primed” to act because of the combined causal conditions of George Floyd’s murder and experiences of COVID-19–related anti-Asian discrimination. Participants were able to mobilize because of the contextual factors of alignment with personal and community values, awareness and knowledge, and perspectives of oppression. The phenomenon of Asian American activists mobilizing in thick solidarity with the BLM movement were influenced by intervening conditions, which included affective responses, intergenerational conflict, conditioning of “privileges” afforded by White supremacy, and organized communities. Each of these conditions and factors interacted to influence non-action, performative or unhelpful action, and action toward thick solidarity.

Participants identified the consequences of pursuing thick solidarity with the Black community as resulting in pathways that facilitate three domains: (a) to promote intraracial and interracial healing, (b) to commit to personal and community values as well as human rights initiatives, and (c) to restructure policies and redistribute power. Within this study, “achieving a collective oppressed identity” occurred most frequently in participant narratives, experiences, and practices and was identified as absolutely critical for mobilization to occur. The core category of achieving a collective oppressed identity arose as a result of George Floyd’s murder, because of experiences of COVID-19–related anti-Asian discrimination, and in the light of awareness and knowledge.

Discussion

A grounded theory analysis with 25 diverse individuals outlined an emergent process describing how contributing factors mobilized Asian American activists toward thick solidarity with the BLM movement in June and July 2020. Understanding and abstracting this theoretical process is important to embolden other Asian American individuals to engage in collective social action. Components of the emergent process are consistent with the CIIM (Gaertner & Dovidio, 2000) and supplement additional studies that explored AAPI support for the BLM movement (Lee et al., 2020; Merseth, 2018; Yoo et al., 2021). Specifically, the theoretical process that emerged from this study illuminates new findings that indicate how achieving a collective oppressed identity and contextualizing the historical relationship between the Asian American and Black communities are critical to empowering AAPI communities to form racial coalitions (Chang, 2020; J. Ho, 2021). For many participants, understanding this history and becoming more racially conscious propelled their motivations for achieving solidarity and dismantling the forces of White supremacy that oppress all racialized groups. This finding reveals numerous perspectives that value historical context and knowledge as a central factor for AAPI activism, especially in tandem with other communities of color (Museus, 2021; Nicholson et al., 2020).

Participants in the study identified how George Floyd’s murder and their experiences of anti-Asian discrimination resulted in an achieved collective oppressed identity that contributed to their mobilization toward thick solidarity with the BLM movement. This finding is consistent with extant research that hypothesized how ingroup discrimination may cultivate increased empathy, positive attitudes, and a collective sense of greater community (Craig & Richeson, 2012; Tajfel & Turner, 1979). The ways that causal conditions identified in this study led to a collective oppressed identity may further be explained through the lens of the CIIM model (Gaertner & Dovidio, 2000), which posits that experiences of racial discrimination can engender positive attitudes and feelings of closeness to other racial minorities. The findings of the study additionally complement earlier studies on AAPI support for BLM that identified race-based linked fate beliefs among Asian Americans as a predictor of BLM support (Merseth, 2018), and an ethnography that identified the importance of organized educational communities for Southeast Asian Americans engaging in activism (Lee et al., 2020). Another possibility may be that participants in the study achieved a dual identity. As explained by Gaertner and colleagues (1994), dual identity occurs when individuals perceive themselves as members of different ethnic or racial groups “playing on the same team” (p. 227)—in this case, to dismantle the forces of White supremacy that continue to oppress all communities of color. The findings from the present study further elaborate on processes that may outline how anti-Asian discrimination can create the impetus for mobilizing in thick solidarity with the Black community (Anand & Hsu, 2020; Li & Nicholson, 2021; R. Liu & Shange, 2018; W. Liu, 2018).

Implications From the Study
The findings from this study can be used by mental health professionals and counselor educators to engage in meaningful racial dialogues and foster interracial coalitions. Specifically, professional counselors can employ this grounded theory to help Asian Americans heal from their own racial and intergenerational trauma by supporting other communities of color. The process of action outlined in our study illuminates the importance of promoting awareness and knowledge about the history of Black and AAPI oppression (Chang, 2020; J. Ho, 2021), connecting AAPI individuals to supportive communities (C. D. Chan & Litam, 2021; Yi et al., 2020), and providing helpful resources (e.g., Letters for Black Lives) and strategies (e.g., exposure and connection with other communities of color) to navigate cultural barriers (Arora & Stout, 2019).

Mental health professionals and social justice advocates can apply these findings to promote engagement in community organizing efforts of AAPI communities with the BLM movement, denounce anti-Blackness, and uphold culpability in supporting the Black community. Following the COVID-19 pandemic, AAPI individuals may experience greater rates of racial discrimination and anti-Asian rhetoric in ways that negatively impact their well-being (C. D. Chan & Litam, 2021; Jeung & Nham, 2020; Litam, 2020; Litam & Oh, 2020, 2021; Litam et al., 2021). Mental health professionals can validate these experiences of oppression and help clients redirect affective experiences in ways that promote awareness and knowledge (David et al., 2019; Museus, 2021), challenge proximity to Whiteness (Poon et al., 2016; Yi et al., 2020), and cultivate meaningful action in racial solidarity movements (Chang, 2020; Litam, 2021; Yoo et al., 2021). Helping Asian American individuals find communities that foster action toward thick solidarity with BLM and exploring how affective experiences influence accountability may be helpful in garnering support. For example, mental health professionals can explore whether limited perspectives of oppression and assimilation strategies may result in inaction or performative action, especially in directly challenging Whiteness (Chang, 2020; Yoon et al., 2016) or intentionally taking accountability for harboring anti-Black sentiments (Museus, 2021). This consideration is especially crucial as AAPIs build long-term solidarity as a proactive approach to Black solidarity rather than a temporary measure. Finally, mental health professionals may encourage AAPI individuals to expand their perspectives to include dual identities as AAPI people and as members of a greater group of oppressed minoritized individuals to foster racial coalitions.

Limitations
First, participants self-selected into the study with a strong working knowledge of their activist and AAPI identities. Readers must therefore be judicious about transferring these findings to AAPI individuals whose activist and/or racial identities may not be fully developed. Second, participants represented a small sample of a larger Asian American community that endorses varying views about activism, anti-Blackness, and other human rights issues. Notably, the sample only included one person with Pacific Islander heritage. Although the importance of thick solidarity continues to gain traction, readers must caution themselves against interpreting these perspectives as a monolithic viewpoint held by all AAPI individuals.

Recommendations for Future Research
The limitations of the study yield additional opportunities to build upon empirical research that illuminates racial coalitions, particularly among communities of color. With the findings of this study, it would be helpful to elucidate critical developmental points that shift AAPI communities into racial consciousness of White supremacy. This developmental point may be complex, given different histories of regions within the United States, migration histories, acculturation rates, and racial socialization within families. Similarly, White supremacy seeks to homogenize AAPI communities as a single racial group solely characterized by educational and economic success (Museus, 2021).

Built upon the premise of this study, it behooves researchers to address how anti-Blackness persists within AAPI communities (Yi et al., 2020; Yoo et al., 2021). Because only one participant had Pacific Islander heritage in the current study, researchers can further explore how Pacific Islanders may (a) endorse anti-Blackness, (b) experience the nexus of racism and colonialism, and (c) shape their commitments to solidarity with Black communities. Based on the themes underpinning the process toward thick solidarity in the study, it may be beneficial for researchers to consider the institutional conditions of their neighborhoods, communities, schools, and workplaces in promoting racial coalitions. Given that the study’s findings emphasized the importance of awareness and knowledge, it would be helpful to engage in qualitative research that further explores how educators in the P–16 system (i.e., preschool to college) map their curriculum of Asian history to include knowledge of racial coalitions, White supremacy, imperialism, and colonialism. Further research may also examine how counselor educators address the complex and racialized experiences of Asian American and Black communities within graduate coursework. Additionally, it is imperative to expand on research that illuminates Black organizers, activists, and communities in racial solidarity movements and Black-Asian racial coalitions.

Conclusion

The results of a grounded theory with diverse Asian American voices illuminated how causal conditions, contextual factors, intervening conditions, actions, and outcomes mobilized Asian Americans toward solidarity with the BLM movement in 2020. Understanding these conditions are of paramount importance to overcoming anti-Black notions embedded within AAPI ethnic subgroups and challenging systemic forms of racial oppression that impact all communities of color.

 

Conflict of Interest and Funding Disclosure
The authors reported no conflict of interest
or funding contributions for the development
of this manuscript.

References

Anand, D., & Hsu, L. (2020). COVID-19 and Black Lives Matter: Examining anti-Asian racism and anti-Blackness in US education. International Journal of Multidisciplinary Perspectives in Higher Education, 5(1), 190–199. https://doi.org/10.32674/jimphe.v5i1.2656
Arora, M., & Stout, C. T. (2019). Letters for Black Lives: Co-ethnic mobilization and support for the Black Lives Matter movement. Political Research Quarterly, 72(2), 389–402. https://doi.org/10.1177/1065912918793222
Blalock, H. M., Jr. (1967). Toward a theory of minority-group relations. Wiley.
Bonacich, E. (1973). A theory of middleman minorities. American Sociological Review, 38(5), 583–594. https://doi.org/10.2307/2094409
Bonilla-Silva, E. (2004). From bi-racial to tri-racial: Towards a new system of racial stratification in the USA. Ethnic and Racial Studies, 27(6), 931–950. https://doi.org/10.1080/0141987042000268530
Bonilla-Silva, E. (2018). Racism without racists: Color-blind racism and the persistence of racial inequality in America (5th ed.). Rowman & Littlefield.
Brewer, M. B. (2000). Reducing prejudice through cross-categorization: Effects of multiple social identities. In S. Oskamp (Ed.), Reducing prejudice and discrimination (pp. 165–183). Erlbaum.
Chan, C. D., & Litam, S. D. A. (2021). Mental health equity of Filipino communities in COVID-19: A framework for practice and advocacy. The Professional Counselor, 11(1), 73–85. https://doi.org/10.15241/cdc.11.1.73
Chan, S. (1991). Asian Americans: An interpretive history. Twayne.
Chang, B. (2020). From ‘illmatic’ to ‘kung flu’: Black and Asian solidarity, activism, and pedagogies in the COVID-19 era. Postdigital Science and Education, 2(3), 741–756. https://doi.org/10.1007/s42438-020-00183-8
Charmaz, K. (2014). Constructing grounded theory (2nd ed.). SAGE.
Charmaz, K. (2017). Special invited paper: Continuities, contradictions, and critical inquiry in grounded theory. International Journal of Qualitative Methods, 16(1), 1–8. https://doi.org/10.1177/1609406917719350
Chou, R. S., & Feagin, J. R. (2016). The myth of the model minority: Asian Americans facing racism. Routledge. https://doi.org/10.4324/9781315636313
Clarke, A. E. (2012). Feminism, grounded theory, and situational analysis revisited. In S. N. Hesse-Biber (Ed.), Handbook of feminist research: Theory and praxis (2nd ed., pp. 388–412). SAGE.
Craig, M. A., & Richeson, J. A. (2012). Coalition or derogation? How perceived discrimination influences intraminority intergroup relations. Journal of Personality and Social Psychology, 102(4), 759–777. https://doi.org/10.1037/a0026481
Creswell, J. W., & Poth, C. N. (2018). Qualitative inquiry & research design: Choosing among five approaches (4th ed.). SAGE.
David, E. J. R. (2013). Brown skin, White minds: Filipino-/American postcolonial psychology. Information Age Publishing.
David, E. J. R., & Okazaki, S. (2006a). Colonial mentality: A review and recommendation for Filipino American psychology. Cultural Diversity and Ethnic Minority Psychology, 12(1), 1–16.
https://doi.org/10.1037/1099-9809.12.1.1
David, E. J. R., & Okazaki, S. (2006b). The Colonial Mentality Scale (CMS) for Filipino Americans: Scale construction and psychological implications. Journal of Counseling Psychology, 53(2), 241–252. https://doi.org/10.1037/0022-0167.53.2.241
David, E. J. R., Schroeder, T. M., & Fernandez, J. (2019). Internalized racism: A systematic review of the psychological literature on racism’s most insidious consequence. Journal of Social Issues, 75(4), 1057–1086. https://doi.org/10.1111/josi.12350
Elias, A., Ben, J., Mansouri, F., & Paradies, Y. (2021). Racism and nationalism during and beyond the COVID-19 pandemic. Ethnic and Racial Studies, 44(5), 783–793. https://doi.org/10.1080/01419870.2020.1851382
Fanon, F. (1952). Black skin, White masks. Grove Press.
Gaertner, S. L., & Dovidio, J. F. (2000). Reducing intergroup bias: The common ingroup identity model. Psychology Press.
Gaertner, S. L., Rust, M. C., Dovidio, J. F., Bachman, B. A., & Anastasio, P. A. (1994). The contact hypothesis: The role of a common ingroup identity on reducing intergroup bias. Small Group Research, 25(2), 224–249. https://doi.org/10.1177/1046496494252005
Gergen, K. J. (2020). Constructionist theory and the blossoming of practice. In S. McNamee, M. M. Gergen, C. Camargo-Borges, & E. F. Rasera (Eds.), The SAGE handbook of social constructionist practice (pp. 3–14). SAGE. https://doi.org/10.4135/9781529714326.n1
Gergen, M. (2020). Practices of inquiry: Invitation to innovation. In S. McNamee, M. M. Gergen, C. Camargo-Borges, & E. F. Rasera (Eds.), The SAGE handbook of social constructionist practice (pp. 17–23). SAGE. https://doi.org/10.4135/9781529714326.n2
Guba, E. G., & Lincoln, Y. S. (1989). Fourth generation evaluation. SAGE.
Haney López, I. (2006). White by law: The legal construction of race (10th ed.). New York University Press.
Hays, D. G., & Singh, A. A. (2012). Qualitative inquiry in clinical and educational settings. Guilford.
Ho, F., & Mullen, B. V. (Eds.). (2008). Afro Asian: Revolutionary political and cultural connections between African Americans and Asian Americans. Duke University Press.
Ho, J. (2021). Anti-Asian racism, Black Lives Matter, and COVID-19. Japan Forum, 33(1), 148–159.
https://doi.org/10.1080/09555803.2020.1821749
Jeung, R., & Nham, K. (2020). Incidents of coronavirus-related discrimination. Asian Pacific Policy & Planning Council. https://bit.ly/3bITRDE
Khan-Cullors, P., & Bandele, A. (2017). When they call you a terrorist: A Black Lives Matter memoir. St. Martin’s Publishing Company.
Kim, C. J. (1999). The racial triangulation of Asian Americans. Politics Society, 27(1), 105–138.
https://doi.org/10.1177/0032329299027001005
Lebron, C. J. (2017). The making of Black Lives Matter: A brief history of an idea. Oxford University Press.
Lee, S. J., Xiong, C. P., Pheng, L. M., & Vang, M. N. (2020). “Asians for Black Lives, not Asians for Asians”: Building Southeast Asian American and Black solidarity. Anthropology & Education Quarterly, 51(4), 405–421. https://doi.org/10.1111/aeq.12354
Li, Y., & Nicholson, H. L., Jr. (2021). When “model minorities” become “yellow peril”—Othering and the racialization of Asian Americans in the COVID-19 pandemic. Sociology Compass, 15(2), 1–13. https://doi.org/10.1111/soc4.12849
Litam, S. D. A. (2020). “Take your Kung-Flu back to Wuhan”: Counseling Asians, Asian Americans, and Pacific Islanders with race-based trauma related to COVID-19. The Professional Counselor, 10(2), 144–156. https://doi.org/10.15241/sdal.10.2.144
Litam, S. D. A. (2021). Rocking the boat: A call for Asian American and Pacific Islander counselors to make waves. Journal of Mental Health Counseling, 43(3), 273–276. https://doi.org/10.17744/mehc.43.3.09
Litam, S. D. A., & Chan, C. D. (2021). Breaking the bamboo ceiling: Practical strategies for Asian American and Pacific Islander counselor educators. Counselor Education and Supervision, 60(3), 174–189. https://doi.org/10.1002/ceas.12210
Litam, S. D. A., & Oh, S. (2020). Ethnic identity and coping strategies as moderators of COVID-19 racial discrimination experiences among Chinese Americans. Counseling Outcome Research and Evaluation. https://doi.org/10.1080/21501378.2020.1814138
Litam, S. D. A., & Oh, S. (2021). Effects of COVID-19 racial discrimination on depression and life satisfaction among young, middle, and older Chinese Americans. Adultspan Journal, 20(2), 70–84. https://doi.org/10.1002/adsp.12111
Litam, S. D. A., Oh, S., & Chang, C. (2021). Resilience and coping as moderators of stress-related growth in Asians and AAPI during COVID-19. The Professional Counselor, 11(2), 248–266.
https://doi.org/10.15241/sdal.11.2.248
Liu, R., & Shange, S. (2018). Toward thick solidarity: Theorizing empathy in social justice movements. Radical History Review, 131, 189–198. https://doi.org/10.1215/01636545-4355341
Liu, W. (2018). Complicity and resistance: Asian American body politics in Black Lives Matter. Journal of Asian American Studies, 21(3), 421–451. https://doi.org/10.1353/jaas.2018.0026
Mendoza, R. L. (2014). The skin whitening industry in the Philippines. Journal of Public Health Policy, 35, 219–238. https://doi.org/10.1057/jphp.2013.50
Merseth, J. L. (2018). Race-ing solidarity: Asian Americans and support for Black Lives Matter. Politics, Groups, and Identities, 6(3), 337–356. https://doi.org/10.1080/21565503.2018.1494015
Miles, M. B., Huberman, A. M., & Saldaña, J. (2020). Qualitative data analysis: A methods sourcebook (4th ed.). SAGE.
Museus, S. D. (2021). The centrality of critical agency: How Asian American college students develop commitments to social justice. Teachers College Record, 123(1), 1–38.
Nadal, K. L. (2021). Filipino American psychology: A handbook of theory, research, and clinical practice (2nd ed.). Wiley. https://doi.org/10.1002/9781119677109
Nicholson, H. L., Jr., Carter, J. S., & Restar, A. (2020). Strength in numbers: Perceptions of political commonality with African Americans among Asians and Asian Americans in the United States. Sociology of Race and Ethnicity, 6(1), 107–122. https://doi.org/10.1177/2332649218785648
Oh, A. E. (2010). An issue of time and place: The truth behind Korean Americans’ connection to the 1992 Los Angeles riots. Asian American Policy Review, 19, 39–48.
Pavlenko, A. (2002). ‘We have room for but one language here’: Language and national identity in the US at the turn of the 20th century. Multilingua, 21(2–3), 163–196. https://doi.org/10.1515/mult.2002.008
Pendakur, S. L., & Pendakur, V. (2016). Beyond boba tea and samosas: A call for Asian American race consciousness. In S. D. Museus, A. Agbayani, & D. M. Ching (Eds.), Focusing on the underserved: Immigrant, refugee, and Indigenous Asian American and Pacific Islanders in higher education (pp. 55–72). Information Age Publishing.
Petrola, J. P., Ledesma, J., Venturillo, C. P., Del Rosario, K. E., & Isidro, R. (2020). The will to self-determination: Understanding the life of Ati people in Aklan, Philippines. Journal of Critical Reviews, 7(11), 218–222. https://doi.org/10.31838/jcr.07.11.35
Poon, O. A., Segoshi, M. S., Tang, L., Surla, K. L., Nguyen, C., & Squire, D. D. (2019). Asian Americans, affirmative action, and the political economy of racism: A multidimensional model of raceclass frames. Harvard Educational Review, 89(2), 201–226. https://doi.org/10.17763/1943-5045-89.2.201
Poon, O., Squire, D., Kodama, C., Byrd, A., Chan, J., Manzano, L., Furr, S., & Bishundat, D. (2016). A critical review of the model minority myth in selected literature on Asian Americans and Pacific Islanders in higher education. Review of Educational Research, 86(2), 469–502. https://doi.org/10.3102/0034654315612205
Rafael, V. L. (2000). White love and other events in Filipino history. Duke University Press.
Saldaña, J. (2021). The coding manual for qualitative researchers (4th ed.). SAGE.
Sharma, N. (2018). The racial studies project: Asian American studies and the Black Lives Matter campus. In C. J. Schlund-Vials (Ed.), Flashpoints for Asian American studies (pp. 48–65). Fordham University Press.
Tajfel, H., & Turner, J. C. (1979). An integrative theory of intergroup conflict. In W. G. Austin & S. Worchel (Eds.), The social psychology of intergroup relations (pp. 33–47). Brooks Cole.
Taylor, K.-Y. (2016). From #BlackLivesMatter to Black liberation. Haymarket Books.
Timonen, V., Foley, G., & Conlon, C. (2018). Challenges when using grounded theory: A pragmatic introduction to doing GT research. International Journal of Qualitative Methods, 17(1), 1–10. https://doi.org/10.1177/1609406918758086
Tran, N., Nakamura, N., Kim, G. S., Khera, G. S., & AhnAllen, J. M. (2018). #APIsforBlackLives: Unpacking the interracial discourse on the Asian American Pacific Islander and Black communities. Community Psychology in Global Perspective, 4(2), 73–84. https://doi.org/10.1285/i24212113v4i2p73
Xu, J., & Lee, J. C. (2013). The marginalized “model” minority: An empirical examination of the racial triangulation of Asian Americans. Social Forces, 91(4), 1363–1397. https://doi.org/10.1093/sf/sot049
Yamashita, R. C., & Park, P. (1985). The politics of race: The open door, Ozawa and the case of the Japanese in America. Review of Radical Political Economics, 17(3), 135–156.
Yi, V., Mac, J., Na, V. S., Venturanza, R. J., Museus, S. D., Buenavista, T. L., & Pendakur, S. L. (2020). Toward an anti-imperialistic critical race analysis of the model minority myth. Review of Educational Research, 90(4), 542–579. https://doi.org/10.3102/0034654320933532
Yoo, H. C., Atkin, A. L., Seaton, E. K., Gabriel, A. K., & Parks, S. J. (2021). Development of a support for Black Lives Matter measure among racially–ethnically diverse college students. American Journal of Community Psychology, 68(1–2), 100–113. https://doi.org/10.1002/ajcp.12498
Yoon, I.-J. (1997). On my own: Korean businesses and race relations in America. University of Chicago Press.

Stacey Diane Arañez Litam, PhD, NCC, CCMHC, LPCC-S, is an assistant professor at Cleveland State University. Christian D. Chan, PhD, NCC, is an assistant professor at the University of North Carolina at Greensboro. Correspondence may be addressed to Stacey Litam, 2121 Euclid Ave., Cleveland, OH 44115, s.litam@csuohio.edu.

Resilience and Coping as Moderators of Stress-Related Growth in Asians and AAPIs During COVID-19

Stacey Diane Arañez Litam, Seungbin Oh, Catherine Chang

 

This exploratory study examined the extent to which coping, resilience, experiences of subtle and blatant racism, and ethnic identity predicted stress-related growth in a national convenience sample of Asians and Asian Americans and Pacific Islanders (AAPIs; N = 326) who experienced COVID-19–related racial discrimination. Our analysis indicated participants with higher levels of coping, resilience, experiences of subtle and blatant racism, and ethnic identity were significantly more likely to cultivate higher levels of stress-related growth. Coping strategies such as self-blame, religion, humor, venting, substance use, denial, and behavioral disengagement significantly moderated the relationship between experiences of racism and stress-related growth. Notably, participants in the study who used mental health services following COVID-19 reported significantly higher levels of racial discrimination, resilience, coping, and stress-related growth compared to Asians and AAPIs who did not use professional mental health services. Mental health professionals are called to utilize culturally sensitive treatment modalities and challenge traditional Western notions that frame coping responses from an individualistic worldview.

Keywords: Asian, Asian American, COVID-19, racial discrimination, stress-related growth

 

Asians and Asian Americans and Pacific Islanders (AAPIs) represent vulnerable ethnic groups that may present with higher rates of mental health distress during COVID-19. Following the global outbreak, rates of discrimination, harassment, and violence toward Asians and AAPIs have substantially increased (Congressional Asian Pacific American Caucus, 2020; Jeung & Nham, 2020). The rise of COVID-19–fueled racism directed toward Asians and AAPI groups, especially individuals who phenotypically appear East Asian, has deleterious effects on their mental health and wellness (Litam, 2020; Litam & Oh, in press, 2020; Wen et al., 2020).

Although Asians who reside in the United States and AAPI groups are both affected by COVID-19–related racial discrimination, mental health professionals must recognize the important distinctions and challenges that exist between Asian internationals and Asian Americans (Anandavalli et al., 2020; Sue et al., 2019). Professional counselors must also consider the vast heterogeneity that characterizes Asian and AAPI ethnic subgroups (Budiman & Ruiz, 2021; Chan & Litam, 2021). Although an extensive overview of the differences between Asians and AAPI ethnic subgroups was beyond the purview of this study, mental health professionals are called to examine how the intersection of client identities (e.g., international status, nationality, ethnic identity, acculturative status, colonization history) may influence the ways in which COVID-19 racial discrimination affects Asian and AAPI clients (Chan & Litam, 2021; Litam, 2020). For the purpose of contributing to the scant literature on the effects of COVID-19 on Asian and AAPI communities, the current study assesses a national convenience sample of Asians and AAPI groups who reported discrimination experiences following the pandemic. Aggregating these distinct populations was not intended to overlook the vast heterogeneity that exists across ethnic subgroups nor to invalidate the unique challenges faced by Asian and AAPI individuals who reside in the United States. Rather, the present study combined Asian and AAPI populations to ascertain a more collective understanding of the ways in which the greater community may be affected by COVID-19–related racial discrimination.

Effects of Racial Discrimination on Asian and AAPI Mental Health
     Extant research illuminated how perceived racial discrimination among Asian and AAPI communities has adverse effects on overall mental health, coping responses, and wellness. Asians and AAPIs who faced race-based discrimination reported higher levels of psychological distress, substance use, anxiety, depression, and suicidal ideation (Choi et al., 2020; Gee et al., 2007; Hwang & Goto, 2008; Le & Ahn, 2011; Leong et al., 2013). Experiences of race-related stress in Asians and AAPIs were also associated with negative outcomes related to well-being (Iwamoto & Liu, 2010; Mossakowski, 2003), self-esteem (Liang & Fassinger, 2008), and social connectedness (Wei et al., 2012). Although the importance of understanding the effects of COVID-19–related racial discrimination on the mental health of Asians and AAPIs has been established (Asmundson & Taylor, 2020; Chan & Litam, 2021; Litam, 2020), a paucity of empirical investigations examines the mental health effects of pandemic-related discrimination among Asians and AAPIs across the life span (Litam & Oh, in press).

Ethnic Identity
     Ethnic identity is the quality of an individual’s affiliation with their ethnic group and includes a sense of belongingness, self-identification, and attitudes toward one’s group (Phinney, 1990). Phinney (1992) outlined four developmental stages based on high and low levels of exploration and commitment. Whereas exploration includes activities and behaviors undertaken to understand the role of one’s ethnicity or race in one’s identity, commitment refers to the affirmation, sense of connection, and clarity about how one’s ethnic or racial identity fits into one’s life and self-concept (Phinney, 1992). Taken together, the two dimensions of exploration and commitment form four statuses of ethnic and/or racial identity development: diffused (low exploration, low commitment), foreclosed (low exploration, high commitment), moratorium (high exploration, low commitment), and achieved (high exploration, high commitment; Erikson, 1968).

The mixed effect of ethnic identity in the relationship between racial discrimination experiences and well-being has been noted across earlier studies. On one hand, existing research has noted that Asians and AAPIs who cultivated strong ethnic identities were more likely to maintain a positive sense of psychological well-being, reported a greater sense of belongingness to their ethnic communities, and responded with greater resilience when racial discrimination occurred (Lee, 2003; Lee & Davis, 2000; Lee & Yoo, 2004; Litam & Oh, in press; Phinney, 2003; Yip & Fuligni, 2002). In the United States, AAPIs with a strong sense of ethnic identity reported a better quality of life and greater levels of spousal support and harmony (Lieber et al., 2001). In one study with 187 Chinese and Chinese Americans, strong ethnic identity moderated the relationship between experiences of COVID-19 discrimination and levels of depression (Litam & Oh, 2020). Levels of exploration and commitment may additionally influence whether ethnic identity buffers or exacerbates well-being among Asians and AAPIs who experience racial discrimination. According to a meta-analysis of 51 studies, Yip and colleagues (2019) asserted that individuals high in exploration reported more negative mental health and riskier health behavior outcomes following experiences of racial discrimination. Conversely, ethnic identity was a protective factor for individuals with high levels of commitment following racial discrimination (Yip et al., 2019).

The moderating effects of ethnic identity on Asian and AAPI mental health may be framed within the context of social identity theory (Tajfel & Turner, 1979) and self-categorization theory (Turner et al., 1987). According to social identity theory (Tajfel & Turner, 1979), individuals are members of many social groups with whom they may identify (e.g., religion, race, ethnicity, gender). Once individuals have determined their social identities, they become invested in maintaining and enhancing their self-concept (Tajfel & Turner, 1979). Social identity theory therefore predicts that individuals who center their identities are better equipped to cope with identity threats to protect their overall self-concept (Tajfel & Turner, 1979). Through the lens of this theory, individuals who strongly identify with their Asian or AAPI identities may be better positioned to engage in coping strategies that buffer the harmful impact of ethnic or racial discrimination.

Self-categorization theory builds on social identity theory by recognizing that individuals can identify with several social groups simultaneously and that some social identities become more psychologically salient than others (Turner et al., 1987). When ethnic identity becomes salient and represents an important component of one’s identity, self-categorization theory predicts that ethnic and racial discrimination will have a stronger negative impact on mental health and wellness outcomes (Turner et al., 1987). Taken together, social categorization theory predicts that positive feelings toward one’s ethnic group may heighten awareness to ethnic discrimination, which may exacerbate the harmful effects of ethnic or racial discrimination (Lee, 2005), whereas social identity theory posits that high regard for one’s ethnic identity may result in a buffering effect to the deleterious effects of racial discrimination (Yip et al., 2019).

Resilience
     Resilience refers to the “personal qualities that enable one to thrive in the face of adversity” (Connor & Davidson, 2003, p. 76). Although responding with resilience in times of stress has been reported across diverse AAPI subgroups, various ethnic groups may conceptualize resilience in unique ways. As a coping strategy, resilience is not limited to how one responds to challenges but also encompasses strategies for goal achievement. For example, Hmong women demonstrated resilience in career development by adopting positive perspectives, focusing on goal achievement, and reflecting on ways to continue improving (Yang, 2014). In another study, Chinese immigrants demonstrated fortitude through the immigration process and continued to thrive in the United States despite living in poverty in a California Chinatown community (Cheng, 2013). Resilience, therefore, consists of a stress response and an enduring phenomenon. Resilience may be fostered through the presence of social support, especially among family members (Lim & Ashing-Giwa, 2013), through the promotion of cultural understanding (i.e., cultivating ethnic identity), engaging in meaningful activities, and developing mental toughness (i.e., resilience; Kim & Kim, 2013).

Coping and Stress Responses
     Individuals evaluate racial discrimination experiences and cope with stressors differently based on their cultural values and beliefs (Lazarus & Folkman, 1984; Tweed & Conway, 2006). Asians and AAPIs who endorse higher levels of ethnic identity may be more likely to employ coping strategies that align with culturally embedded values (Miller & Kaiser, 2001; Miller & Major, 2000). These cultural values may assert the importance of adjusting one’s feelings to fit their environment, accepting rather than confronting problems, preserving social harmony, avoiding problem disclosure (Inman & Yeh, 2007; Tweed & Conway, 2006; Yeh et al., 2006), and evading conflict to preserve interpersonal relationships (Noh & Kaspar, 2003). These passive forms of coping may be problematic, as avoidant and emotion-focused responses may contribute to poorer mental health outcomes in AAPIs.

Other culturally congruent coping responses such as social isolation, which protects the user by avoiding the stressor (Edwards & Romero, 2008); self-blame or criticizing oneself, which maintains interpersonal harmony (Wei et al., 2010); and substance use (Pokhrel & Herzog, 2014), which momentarily helps one evade problems or adjust one’s feelings to the environment, may also be preferred by Asians and AAPIs. Following stressful events, social isolation has been strongly linked to increased symptoms of depression and anxiety, decreased feelings of self-worth, and lower levels of life satisfaction (Cacioppo & Hawkley, 2003; Cacioppo et al., 2002).

Stress-Related Growth
     Individuals may respond to stressful life events, transitions, and traumatic experiences with positive psychological changes (Park et al., 1996; Tedeschi & Calhoun, 2004). Researchers posit that coping strategies (Helgeson et al., 2006; Janoff-Bulman, 2004; Tedeschi & Calhoun, 2004), higher levels of self-esteem, positive spiritual changes, and increased social support (Linley & Joseph, 2004; Tedeschi & Calhoun, 1995, 2004) may arise following experiences of stress. According to Tedeschi and Calhoun (1996, 2004), examples of stress-related growth may include pursuing new possibilities, having a greater appreciation for life, cultivating meaningful relationships, enhancing spiritual growth, and developing personal strengths. A meta-analysis of 103 studies identified the presence of coping strategies, cognitive reappraisal, religion, optimism, and social support as significant predictors for stress-related growth (Prati & Pietrantoni, 2009). A qualitative study with Korean immigrants indicated the use of coping strategies was a predictor for stress-related growth (Kim & Kim, 2013).

Tedeschi and Calhoun (1996, 2004) conceptualized stress-related growth as both a long-term outcome and a process. For instance, stress-related growth has been conceptualized as a coping strategy following traumatic events (Nolen-Hoeksema & Davis, 2004) and may occur as the result of ongoing medical conditions such as cancer (Cordova et al., 2017) and chronic pain (Rzeszutek & Gruszczyńska, 2018), wherein traumatic experiences are not time-limited. Thus, stress-related growth may result from the ongoing process of awareness, adaptation, and concern related to medical, psychological, and social consequences associated with the conditions of living (Edmondson et al., 2011). Given the precedence of emerging research that measures stress-related growth during COVID-19 (Vasquez et al., 2021), stress-related growth was included as an outcome variable in our study. This variable was of particular interest because research remains forthcoming on the contributing factors to stress-related growth among Asians and AAPIs following experiences of stress related to COVID-19.

The call to identify moderators of mental health in Asian and AAPI communities following racial discrimination has been established (Litam, 2020; Litam & Oh, in press; Nadal et al., 2015; Wong et al., 2014). It is of paramount importance to identify race-related response strategies to develop culturally sensitive and effective counseling interventions (Chan & Litam, 2021; Frazier et al., 2004; Litam & Hipolito-Delgado, 2021). The relationship between COVID-19–fueled racial discrimination, ethnic identity, resilience, and coping responses in Asian and AAPI populations remains to be seen and necessitates special consideration for mental health professionals. Understanding this relationship is crucial when considering how Asians and AAPIs tend to avoid health care services (DeVitre & Pan, 2020; Sue et al., 2019). To address this paucity of literature, this study was undertaken to examine the following research questions:

  1. To what extent do coping, resilience, experience of racism, and ethnic identity predict stress-related growth following COVID-19?
  2. To what extent does coping moderate experiences of COVID-19–related racism and stress-related growth?
  3. To what extent does resilience moderate experiences of COVID-19–related racism and stress-related growth?

Method

Participants
     Data was collected from June to July 2020. A total of 409 Asian and AAPI individuals were recruited through AAPI listservs and community organizations (n = 10) and Amazon MTurk (n = 399). Sixty-eight respondents from Amazon MTurk completed less than 50% of the survey items, so their associated surveys were removed from the data. An additional 11 respondents from Amazon MTurk endorsed all survey items with the same response or incorrectly answered validity items, and their surveys were also eliminated from the data. Lastly, four multivariate outliers were removed (i.e., Mahalanobis distance value > 20.515 at a = .001), resulting in a final sample of 326 cases (79.7% useable response rate). The final sample (N = 326) met sufficient sample size for hierarchical multiple regression (N > 94) and a path analysis (N > 134; O’Rourke & Hatcher, 2013) at a = .01 to identify medium effect size.

 

Table 1

Descriptive Characteristics and Correlations

Characteristic Frequency %
Gender
Male 225 69.0%
Female 101 31.0%
Education Level
High School Diploma or the equivalent 6 1.8%
Associate Degree 6 1.8%
Bachelor’s Degree 205 62.9%
Master’s Degree 95 29.1%
Doctorate Degree 14 4.3%
Sexual Identity
Heterosexual 220 67.5%
Gay or Lesbian 9 2.8%
Bisexual, Pansexual, or Non-Monosexual 91 27.9%
Other 6 1.8%
Seeking Mental Health Service Since COVID-19
Yes 153 46.9%
No 149 45.7%
No, but I have considered it 24 7.4%
Variable a M SD 1 2 3 4 5
SBRS .91 27.48 7.28
SRGS .95 77.05 15.09 .510**
MEIM .61 22.56 3.20 .437** .429**
Resilience .95 134.92 20.97 .301** .703** .436**
Coping .92 79.05 13.10 .662** .699** .521** .518**

 Note. SBRS = Subtle and Blatant Racism Scale; SRG = Stress-Related Growth Scale; MEIM = Multigroup
Ethnic Identity Measure.
**p < .01

 

Table 1 presents details regarding descriptive characteristics of participants in this study. The average age of Asian and AAPI participants was 33.79 years (SD = 9.19), ranging from 18 to 72 years. The majority of participants identified as male (69.0%, n = 225), and a smaller group identified as female (31%; n = 101). Most participants reported having an international status (72.7%, n = 237), whereas 27.3% of participants (n = 89) identified as an American citizen or permanent U.S. resident. For one item, “Have you sought professional mental health counseling services since COVID-19?” approximately half of the participants (46.9%, n = 153) selected “Yes,” a total of 150 participants (45.7%) selected “No,” and a total of 24 participants (7.4%) indicated “No, but I’ve considered it.”

Procedures
     IRB approval from relevant universities was obtained prior to data collection. Potential participants were recruited using non-probability convenience sampling with inclusion criteria. Participants who (a) self-identified as Asian or Asian American, (b) resided in the United States, and (c) had either directly or indirectly experienced COVID-19–related racism were able to participate in the study. Participants from the MTurk obtained $0.50 as an incentive for their completion of the survey. To ensure the quality of data, the survey included two validity items that asked participants to choose specific response options. Participants who chose incorrect responses were automatically excluded from participation in the survey. 

Measures
Demographics and Background Form
     A demographics/background information form was created to gather information regarding participants’ age, gender, highest level of education, race/ethnicity, sexual identity, income level, occupation, international status, religion, and generational status. Additional survey items assessed English proficiency and how rates of discrimination evidenced through verbal, covert, online, and physical harassment may have changed following COVID-19. Participants were provided with the option to input text describing additional forms of racial discrimination experienced since COVID-19.

Multigroup Ethnic Identity Measure – Revised (MEIM-R)
     The Multigroup Ethnic Identity Measure (MEIM; Phinney, 1992) is a 14-item scale that assesses three aspects of ethnic identity: positive ethnic attitudes and a sense of belonging (five items), ethnic identity achievement (seven items), and ethnic behaviors or practices (two items). The measure is scored by reversing negatively worded items, summing the scores across each item, and obtaining the mean. Scores range from 4 (high ethnic identity) to 1 (low ethnic identity). Overall reliability was .90 in a college sample, and the results of a principal axis factor analysis using squared multiple correlations supported the presence of two factors, ethnic identity and other-group group orientation, accounting for 30.8% and 11.4% in college samples, respectively (Phinney, 1992). The MEIM was shortened into a six-item scale that measures two subscales, Identity Exploration and Identity Commitment (MEIM-R; Brown et al., 2014). Example items include “I have spent time trying to find out more about my own ethnic group, such as its history, traditions, and customs” and “I think a lot about how my life will be affected by my ethnic group membership.” The MEIM-R demonstrated adequate internal consistency for the overall scale and two subscales with all Cronbach alpha values near or above .70 (Brown et al., 2014). Based on the results of multiple-groups confirmatory factor analyses, the MEIM-R demonstrated evidence of measurement invariance, had good psychometric properties, and is an appropriate measure of ethnic identity across diverse Asian subgroups (Brown et al., 2014).

Resilience Scale (RS)
     The Resilience Scale (RS; Wagnild & Young, 1993) is a 25-item measure that uses a 7-point Likert-type scale from 1 (strongly disagree) to 7 (strongly agree). Example items include “I usually manage one way or another” and “I feel that I can handle many things at a time.” The RS demonstrated a coefficient alpha of .91 with item-to-total correlations ranging from .37 to .75. The concurrent validity of the RS was also robust and was strongly associated with measures of life satisfaction, morale, and depression. The results of a factor analysis indicated the RS is a reliable measure that demonstrated good internal consistency reliability, concurrent validity, and preliminary construct validity (Wagnild & Young, 1993). 

Subtle and Blatant Racism Scale for Asian Americans Revised (SABRA-A2)
The Subtle and Blatant Racism Scale for Asian Americans Revised (SABRA-A2; Yoo et al., 2010) is an 8-item measure that uses a 5-point Likert-type scale from 1 (almost never) to 5 (almost always) to assess the presence of subtle and blatant forms of racial discrimination. The total score is obtained by summing the responses across each of the items, with higher scores indicating greater perceived racism. Example items include “In America, I am faced with barriers in society because I’m Asian” and “In America, I have been physically assaulted because I’m Asian.” Support for the two-subscale structure was confirmed through an exploratory and confirmatory factor analysis with evidence of good internal reliability and stability over 2 weeks (Yoo et al., 2010). The SABRA-A2 also demonstrated good discriminant validity as evidenced by no correlations with color-blind racial attitudes (Yoo et al., 2010).

Brief COPE
     The Brief COPE (Carver, 1997) is a 28-item measure and uses a 4-item Likert-type scale to measure the extent to which participants report using various coping strategies. The measurement has 14 subscales that include two items each. Available responses are 1 (I haven’t been doing this at all), 2 (I’ve been doing this a little bit), 3 (I’ve been doing this a medium amount), and 4 (I’ve been doing this a lot). Example items include “I’ve been concentrating my efforts on doing something about the situation I’m in” and “I’ve been criticizing myself.” The Brief COPE has demonstrated acceptable psychometric properties and has been used with Asian populations (Sue et al., 2019). Cronbach’s alpha for the entire scale is .92 in the current study. Cronbach’s alpha for each of the 14 subscales ranged from .34 to .65. Given the poor reliability for the subscales, the present study utilized the total score for the entire scale.

Stress-Related Growth Scale Revised (SRGS-R)
     The Stress-Related Growth Scale Revised (SRGS-R; Boals & Schuler, 2018), is a 15-item measure that assesses the extent to which participants experience change following a negative event. The scale uses a bipolar 7-point Likert-type scale from −3 (a very negative change) to +3 (a very positive change), and example items include “I experienced a change in the extent to which I listen when others talk to me” and “I experienced a change in my belief that I have something of value to teach others about life.” The SRGS-R demonstrated acceptable measures of convergent validity and stronger associations with outcome measures of mental health, including depression, anxiety, global distress, and post-traumatic symptoms (Boals & Schuler, 2018). Compared to other measures, the SRGS-R may be a more accurate measure for human resiliency as evidenced by the neutral wording of each item and the inclusion of items that avoid measuring illusory growth (Boals & Schuler, 2018).

Data Diagnostics
     Examining the proportion of missing data indicated that 88% of participants reported no missing values, and 83% of the items were not missing data for any case. The proportion of missing data for the rest of the 17% of the items ranged from 2.7% to 16.8%. The degree and pattern of missing data were examined to determine whether data were missing at random. A matrix of the estimated means with each pattern yielded no particular patterns nor severe degree of missing data, which supported evidence for proceeding with missing data replacement techniques. Missing data points were populated using multiple imputation (MI), a method to allocate missing data without causing inflated bias even when there is a large portion of missingness in the data (Osborn, 2013).

     Next, the assumptions of normality, linearity, homoscedasticity, and multicollinearity were tested. The residuals were linear and did not deviate from normality as evidenced by the residuals lying reasonably in a straight, diagonal line. The assumption of homoscedasticity was also supported, as most of the residuals were concentrated along the zero point. All variance inflation factor (VIF) values were less than 10 and tolerance values were greater than .1, indicating absence of multicollinearity (Tabachnick & Fidell, 2019). Therefore, the data were deemed appropriate for hierarchical regression and path analysis (Tabachnick & Fidell, 2019).

Analytic Strategy
     Hierarchical regression models of stress-related growth were employed using SPSS version 27. First, gender, age, education status, sexual identity, and help-seeking experience were entered in Model 1 as the control variables. In Model 2, the first independent variable of subtle and blatant racism was added. In Model 3, the second independent variable of ethnic identity was entered. Finally, the remaining two independent variables of resilience and coping strategy were added as key predictors that may function as potential moderators in Model 4.

To examine potential moderating roles of resilience and coping strategy in the relationship between racism and stress-related growth, Hayes’ (2018) PROCESS macro version 3.5 was conducted. Specifically, 10,000 bootstrapping resampling was conducted to produce 95% percentile confidence intervals (CIs) for the moderating effect. If the CIs excluded zero, moderating effect was considered to be significant. Furthermore, the moderating effects were examined utilizing three conditional values of moderators (Hayes, 2018; Preacher et al., 2017), which included low (the mean score of the moderator −1 SD), moderate (the mean score), and high values (the mean score of the moderator +1 SD). Bodner’s (2017) formula was used to calculate effect size across moderator values. All predictors and moderators were mean-centered for more meaningful interpretation of moderating effect (Hayes, 2018).

Results

Preliminary Analyses
     Descriptive characteristics are found in Table 1. Male and female participants reported similar mean scores on all measurements, except the SABRA-A2. Female participants reported experiencing significantly higher levels of racism (M = 29.10, SD = 6.25) than their male counterparts (M = 26.75, SD = 7.59), with a small effect size (d = 0.34; Cohen, 1998). Participants who had sought mental health services since COVID-19 reported significantly higher resilience scores (M = 138.78, SD = 20.59), experiences of subtle and blatant racism (M = 29.99, SD = 6.38), coping strategy (M = 84.34, SD = 12.61), and stress-related growth (M = 81.13, SD = 14.25) than participants who either did not seek professional mental health services or who considered seeking services, but had not used them.

Correlations
     Correlational analyses among all study variables were conducted. Table 1 presents the correlations among the predictive and outcome variables assessed in the study as well as the mean and standard deviations for each variable and internal reliability for each measurement. As expected, ethnic identity, resilience, coping strategy, and stress-related growth were positively and moderately correlated with each other. Interestingly, subtle and blatant racism were also positively related to ethic identity, resilience, coping, and stress-related growth.

Hierarchical Regression Analyses
     Results from the hierarchical regression analyses are provided in Table 2. The control variables of gender, age, education status, sexual identity, and help-seeking experience were examined in Model 1. Among the control variables, education status, sexual identity, and help-seeking experiences were significantly associated with stress-related growth for Asians and AAPIs. Specifically, participants who had earned a master’s degree or higher and identified as heterosexual had significantly lower scores of stress-related growth compared to those who did not identify as heterosexual. Moreover, participants who sought mental health services following the COVID-19 outbreak reported significantly higher scores of overall stress-related growth compared to those who did not use professional mental health services. Model 1 accounted for 11.6% of the variance in stress-related growth.

The direct effects of subtle and blatant racism on stress-related growth were examined in Model 2. Subtle and blatant racism had a significantly positive relationship with stress-related growth among Asians and AAPIs (β = .456, p < .001) after controlling for gender, age, education, sexual identity, and help-seeking experience. Thus, higher levels of subtle and blatant racism were correlated with higher levels of stress-related growth. Among the control variables, only education status was found to be significantly associated with stress-related growth. Model 2 explained 28.8% of the variance in stress-related growth. The addition of subtle and blatant racism accounted for a 17.2% increase in the explained variance in stress-related growth, which was deemed a medium effect size (Cohen, 1998).

Ethnic identity was added in Model 3. Results indicated that ethnic identity was significantly positively associated with stress-related growth for Asians and AAPIs (β = .244, p < .001) after controlling for gender, age, education, sexual identity, and help-seeking experience. Based on these results, participants in the study who endorsed stronger levels of ethnic identity were more likely to cultivate higher levels of stress-related growth. Model 3 accounted for 33.5% of the variance in stress-related growth. The addition of ethnic identity explained 4.7% of increase in the variance of stress-related growth.

Resilience and coping strategy were added and analyzed in Model 4. Both resilience and coping strategy had significantly positive associations with stress-related growth for Asians and AAPIs after controlling for gender, age, education, sexual identity, and help-seeking experience. Specifically, Asians and AAPIs who had higher levels of resilience and higher levels of coping strategy were more likely to develop higher levels of stress-related growth. Model 4 explained 66.2% of the variance in stress-related growth. The addition of resilience and coping strategy accounted for a 32.7% increase in the explained variance in stress-related growth, which represented a large effect size (Cohen, 1998).

Moderating Effect of Resilience and Coping Strategy
     To examine the moderating effect of resilience and coping strategy, Hayes’ (2018) PROCESS macro (Model 1) was employed using 10,000 bootstrapping resamples. As shown in Table 3, coping strategy was significantly positively related to the slope of subtle and blatant racism on stress-related growth
(β = .017, p < .001). Based on these results, coping strategy significantly moderated (i.e., strengthened) the positive link between racism and stress-related growth. As the moderator, coping strategy explained 1.4% of the total variance (51.2%) in stress-related growth, yielding a small effect size (Cohen, 1998). The nature of the moderating effect is presented in the simple slope analyses (Figure 1). Subtle and blatant racism had a significant effect on the development of stress-related growth for Asians and AAPIs with higher levels of coping strategy (+1 SD; b = .468, 95% CI [.169, .767]), but the significant effect did not hold for those with lower levels of coping strategy (−1 SD; b = .017, 95% CI [−.224, .257]). A +2 SD increase in resilience yielded less than .001 change in the conditional effect on stress-related growth, which was small in magnitude (Bodner, 2017). Thus, resilience did not significantly moderate the link between racism and stress-related growth.

 

Table 2

Results From Hierarchical Multiple Regression and Moderated Path Analysis

Model 1 Model 2 Model 3 Model 4
Variables Β (S.E.) β Β (S.E.) β Β (S.E.) β Β (S.E.) β
Gender

Female (ref)

   Male −1.668

(1.718)

−.051 .187

(1.559)

.006 −.036

(1.510)

−.001 −1.831

(1.085)

−.056
Age

> 34 (ref)

  ≤ 34 −1.205
(1.623)
−.039 −2.059

(1.462)

−.067 −2.287

(1.417)

−.074 .397

(1.027)

.013
Education

≤ Bachelor (ref)

≥ Master −5.017

(1.698)

−.157** −3.470

(1.537)

−.109* −2.249

(1.510)

−.070 .320

(1.090)

.010
Sexual Identity

Non-hetero (ref)

   Heterosexuality −4.479

(1.697)

−.139** −1.721

(1.557)

−.109 −1.621

(1.508)

−.050 −1.512

(1.090)

−.047
Help-Seeking

No (ref)

   Yes 6.796

(1.605)

.225*** 2.691

(1.517)

.089 2.880

(1.469)

.095 .452

(1.065)

.015
SBRS .947

(.108)

.456*** .734

(.114)

.354*** .220

(.095)

.106*
MEIM 1.152

(.243)

.244*** −.172

(.190)

−.037
Resilience .357

(.029)

.496***
Coping .433

(.059)

.375***
R2 .116 .288 .335 .662
∆ R2 .172 .047 .327

 Note. Β = unstandardized regression coefficients; S.E. = standard errors; β = standardized coefficients; SBRS = Subtle and Blatant Racism Scale; MEIM = Multigroup Ethnic Identity Measure; ref = reference group.
*p < .05. **p < .01. ***p < .001

 

Table 3

Results From Moderation Path Analysis

Variable β SE LLCI ULCI
SBRS 0.242* 0.115 0.015 0.469
Coping 0.718*** 0.062 0.596 0.841
SBRS × Coping 0.017** 0.006 0.006 0.029
Controlled Variables
    Age −1.420 1.215 −3.811 0.971
    Gender −0.681 1.297 −3.232 1.871
    Education −1.409 1.287 −3.942 1.124
    Sexual Identity 0.185 1.304 −2.380 2.750
    Help-Seeking 0.070 1.282 −2.452 2.592
SBRS 0.577*** 0.089 0.403 0.751
Resilience 0.443*** 0.029 0.387 0.499
SBRS × Resilience 0.001 0.004 −0.006 0.009
Controlled Variables
    Age 0.472 1.109 −1.709 2.654
    Gender −1.704 1.175 −4.015 0.607
    Education -0.084 1.174 −2.227 2.395
    Sexual Identity −2.569* 1.184 −4.899 −0.239
    Help-Seeking 1.542 1.138 −0.696 3.781

Note. SBRS = Subtle and Blatant Racism Scale; LLCI = lower limit of confidence interval; ULCI = upper limit
of confidence interval.
*p < .05. **p < .01. ***p < .001.

 

Supplementary Analyses
     Because the 14 coping subscales demonstrated poor reliability, we examined which types of coping strategies moderated the link between racism and stress-related growth. Among the different types of coping responses, self-blame, religion, humor, venting, substance use, denial, and behavioral disengagement had significant moderation effects on the relation between racism and stress-related growth. On the contrary, self-distraction, active coping, use of emotional support, use of instrumental support, positive reframing, planning, and acceptance did not significantly moderate the relationship between racism and stress-related growth.

 

Figure 1 

Coping Strategy Moderates the Effect of Subtle and Blatant Racism on Stress-Related Growth


Discussion

The present study examined the extent to which coping, resilience, experiences of racism, and ethnic identity predicted stress-related growth in a national convenience sample of Asian and AAPI individuals. The results of our exploratory study provide empirical evidence for the moderating effects of coping on the relationship between racial discrimination and stress-related growth in Asians and AAPIs following the COVID-19 pandemic. In our study, ethnic identity was positively associated with stress-related growth, which further supports the current body of research linking ethnic identity to well-being (Iwamoto & Liu, 2010; Mossakowski, 2003; Yip et al., 2019). Our findings may be additionally explained through the lens of social identity theory (Tajfel & Turner, 1979), which posits that individuals who strongly identify with their social identities (i.e., ethnic and/or racial identities) are better equipped to leverage effective coping strategies that protect their overall self-concept and buffer the harmful impact of discrimination.

Participants in the study who used mental health services following COVID-19 also reported significantly higher levels of racial discrimination, resilience, coping, and stress-related growth compared to Asians and AAPIs who did not use professional mental health services. The results from our study are consistent with existing research that asserted how individuals may cultivate coping responses following traumatic experiences (Helgeson et al., 2006; Janoff-Bulman, 2004; Tedeschi & Calhoun, 2004) in ways that can strengthen the relationship between stressful experiences (i.e., racism) and stress-related growth (Park et al., 1996; Tedeschi & Calhoun, 2004). The results of our study therefore contribute to a larger body of research that establishes the relationship between stress-related growth and psychological health, optimism, positive affect, and psychological well-being (Bostock et al., 2009; Bower et al., 2009; Durkin & Joseph, 2009) while contributing nascent findings to the relationship between COVID-19 racial discrimination and stress-related growth in Asian and AAPI communities.

The results from Model 1 indicated education status, sexual identity, and help-seeking experiences were significantly associated with stress-related growth for Asians and AAPIs in the study. Specifically, participants who reported higher levels of education and identified as heterosexual or straight had lower scores of stress-related growth compared to those who did not identify as heterosexual. These findings are notable as individuals with lesbian, gay, bisexual, and other marginalized identities experience more stress and mental health issues compared to their heterosexual counterparts (Mongelli et al., 2019), resulting in greater opportunities to cultivate coping responses, build resilience, and establish meaningful social supports (Helgeson et al., 2006; Janoff-Bulman, 2004; Tedeschi & Calhoun, 2004). Participants in our study who used mental health services following the COVID-19 outbreak reported significantly higher levels of stress-related growth compared to Asians and AAPIs who did not use professional mental health services. One possible explanation for this finding may be that participants who sought mental health services already demonstrated higher levels of psychological mindedness, which may have influenced higher levels of stress-related growth following COVID-19–related racial discrimination.

In our study, the combined effects of resilience and coping explained 66.2% of the variance in Model 4, with coping strategies moderating the relationship between experiences of racism and stress-related growth. Participants in our study may have learned cognitive coping responses in the therapeutic setting that mitigated the effects of racism and cultivated stress-related growth. Our findings are consistent with the results of a meta-analysis (n = 103) that identified coping responses such as reappraisal, acceptance, and support seeking as significant predictors of stress-related growth (Prati & Pietrantoni, 2009). The specific coping responses that moderated the link between racism and stress-related growth in this study were self-blame, religion, humor, venting, substance use, denial, and disengagement. Leveraging these coping strategies in response to stressful experiences may be consistent with culturally congruent coping responses that protect Asians and AAPIs by avoiding the stressor (Edwards & Romero, 2008; Litam, 2020). Consistent with extant research on culturally congruent coping, engaging in self-blame responses may maintain interpersonal harmony (Wei et al., 2010), and humor, venting, denial, disengagement, and substance use may help one evade problems or adjust one’s feelings to the environment (Pokhrel & Herzog, 2014). The results of our study are thus consistent with research that emphasizes the influence of cultural notions on coping responses (Lazarus & Folkman, 1984; Tweed & Conway, 2006) while contributing new findings about which coping responses may contribute to stress-related growth in Asian and AAPI communities following COVID-19.

Implications for Counselors
     This study highlights how experiences of racism, ethnic identity, resilience, and coping strategies may cultivate stress-related growth among Asian and AAPI individuals who experience COVID-19–related racial discrimination. Each of these variables were found to predict stress-related growth in our study. Mental health professionals working with Asian and AAPI clients who have experienced COVID-19 racism are encouraged to consider how their clients’ ethnic identity, resilience, and coping strategies may be leveraged to promote their well-being. In this exploratory study, participants with higher levels of ethnic identity experienced greater levels of stress-related growth, so it may behoove mental health professionals to embolden Asian and AAPI clients to fortify the quality of their ethnic group affiliation by pursuing cultural practices that promote a sense of group belongingness (Phinney, 1990). For example, ethnic identity can be cultivated by fostering community connection through local Asian and AAPI organizations, embracing cultural notions, and learning more about one’s culture, background, and family history (Chan & Litam, 2021; Litam, 2020). Clients who embody strong ethnic identities may be more likely to employ coping strategies that align with culturally embedded values; therefore, it is essential that mental health counselors recognize their own cultural values while remaining respectful of their client’s cultural values (Chang & O’Hara, 2013; see MSJCC, Ratts et al., 2016).

Given the importance of coping strategies and resilience on stress-related growth, mental health professionals are encouraged to identify and amplify clients’ existing coping strategies while fostering responses that cultivate resilience. Though limited, a supplementary analysis indicated that different forms of coping, such as self-blame, religion, humor, venting, substance use, denial, and disengagement, may moderate the relationship between racism and stress-related growth among Asian and AAPI communities facing racial discrimination following COVID-19. Thus, mental health professionals working with Asian and AAPI clients must assess the intention and outcome of client coping responses and challenge individualistic assumptions that minimize the value of culturally congruent coping strategies. The importance of using culturally sensitive therapeutic interventions when supporting Asian and AAPI clients during COVID-19 has been established (Litam, 2020). For example, mental health professionals must challenge assumptions that disengagement coping strategies are inherently problematic for their Asian and AAPI clients (Wong et al., 2010). Instead, mental health professionals are encouraged to focus on the usefulness of their Asian and AAPI clients’ coping strategies without imposing their own preconceived notion of what healthy and unhealthy coping entails. Of note, substance use was identified as a coping strategy used by participants in this study. Counselors are therefore called to examine the purpose and outcomes associated with client substance use with nuance to determine the extent to which ongoing substance use may contribute to mental health sequelae.

Limitations and Future Areas of Study
     The results of the study must be interpreted within the context of methodological limitations. First, although all participants resided in the United States, the majority of participants held international statuses compared to U.S. citizens or permanent residents. Readers must be cautioned before generalizing these findings to AAPIs, who may endorse generational differences. Next, it is possible that participants recruited from MTurk may not be representative of the general Asian and AAPI population in the United States (Burnham et al., 2018). Future areas of research may consider incorporating various strategies to recruit more representative samples. Additional areas of investigation may also examine how generational identity may affect the extent to which coping, resilience, racism, and ethnic identity predict stress-related growth. Next, although a significant positive association was found between using professional mental health services and levels of resilience, racism, coping, and stress-related growth, it is unknown whether participants in the study already embodied higher levels of stress-related growth, coping, and resilience before seeking services. Future areas of study may examine whether these variables may actually predict help-seeking behaviors in Asians and AAPIs. For example, seeking professional mental health services is consistent with predictors of stress-related growth, including leveraging community support, engaging in cognitive responses, appraisal, and facilitating meaning making (Park & Fenster, 2004; Prati & Pietrantoni, 2009). Moreover, the validity of the findings from the supplementary analysis could be limited because of the low reliability of 14 subscales. Finally, Asians and AAPIs were aggregated in the study, which results in the loss of important within-group distinctions. Future studies are warranted that investigate the extent to which coping, resilience, racism, and ethnic identity predict stress-related growth in specific Asian and AAPI subgroups.

Conclusion

     Asians and AAPIs who employ culturally congruent coping responses may experience greater levels of stress-related growth following experiences of COVID-19–related racial discrimination. In this study, higher levels of ethnic identity, resilience, and coping responses predicted stress-related growth in a national convenience sample of Asians and AAPIs residing in the United States. Asians and AAPIs in this study who sought professional mental health services reported higher levels of racism and endorsed higher scores of resilience, coping, and stress-related growth compared to those who did not seek professional mental health services. Mental health professionals are encouraged to support Asian and AAPI clients in strengthening their ethnic identity, building resilience, and using culturally congruent coping responses to mitigate the effects of COVID-19–related racism and promote the development of stress-related growth.

 

Conflict of Interest and Funding Disclosure
The authors reported no conflict of interest
or funding contributions for the development
of this manuscript.

 

References

Anandavalli, S., Harrichand, J. J. S., & Litam, S. D. A. (2020). Counseling international students in times of uncertainty: A critical feminist and bioecological approach. The Professional Counselor, 10(3), 365–375. https://doi.org/10.15241/sa.10.3.365

Asmundson, G. J. G., & Taylor, S. (2020). Coronaphobia: Fear and the 2019-nCoV outbreak. Journal of Anxiety Disorders, 70. https://doi.org/10.1016/j.janxdis.2020.102196

Boals, A., & Schuler, K. L. (2018). Reducing reports of illusory posttraumatic growth: A revised version of the Stress-Related Growth Scale (SRGS-R). Psychological Trauma: Theory, Research, Practice, and Policy, 10(2), 190–198. https://doi.org/10.1037/tra0000267

Bodner, T. E. (2017). Standardized effect sizes for moderated conditional fixed effects with continuous moderator variables. Frontiers in Psychology, 8, 562. https://doi.org/10.3389/fpsyg.2017.00562

Bostock, L., Sheikh, A. I., & Barton, S. (2009). Posttraumatic growth and optimism in health-related trauma: A systematic review. Journal of Clinical Psychology in Medical Settings, 16(4), 281–296. https://doi.org/10.1007/s10880-009-9175-6

Bower, J. E., Moskowitz, J. T., & Epel, E. (2009). Is benefit finding good for your health? Pathways linking positive life changes after stress and physical health outcomes. Current Directions in Psychological Science, 18(6), 337–341. https://doi.org/10.1111/j.1467-8721.2009.01663.x

Brown, S. D., Unger Hu, K. A., Mevi, A. A., Hedderson, M. M., Shan, J., Quesenberry, C. P., & Ferrara, A. (2014). The Multigroup Ethnic Identity Measure–Revised: Measurement invariance across racial and ethnic groups. Journal of Counseling Psychology, 61(1), 154–161. https://doi.org/10.1037/a0034749

Budiman, A., & Ruiz, N. G. (2021). Key facts about Asian Americans, a diverse and growing population. Pew Research Center. https://www.pewresearch.org/fact-tank/2017/09/08/key-facts-about-asian-americans

Burnham, M. J., Le, Y. K., & Piedmont, R. L. (2018). Who is MTurk? Personal characteristics and sample consistency of these online workers. Mental Health, Religion & Culture, 21(9–10), 934–944. https://doi.org/10.1080/13674676.2018.1486394

Cacioppo, J. T., & Hawkley, L. C. (2003). Social isolation and health, with an emphasis on underlying mechanisms. Perspectives in Biology and Medicine, 46(3), S39–S52. https://doi.org/10.1353/pbm.2003.0063

Cacioppo, J. T., Hawkley, L. C., Crawford, L. E., Ernst, J. M., Burleson, M. H., Kowalewski, R. B., Malarkey, W. B., Van Cauter, E., & Berntson, G. G. (2002). Loneliness and health: Potential mechanisms. Psychosomatic Medicine, 64(3), 407–417. https://doi.org/10.1097/00006842-200205000-00005

Carver, C. S. (1997). You want to measure coping but your protocol’s too long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4(1), 92–100. https://doi.org/10.1207/s15327558ijbm0401_6

Chan, C. D., & Litam, S. D. A. (2021). Mental health equity of Filipino communities in COVID-19: A framework for practice and advocacy. The Professional Counselor, 11(1), 73–85. https://doi.org/10.15241/cdc.11.1.73

Chang, C. Y., & O’Hara, C. (2013). The initial interview with Asian American clients. Journal of Contemporary Psychotherapy, 43(1), 33–42. https://doi.org/10.1007/s10879-012-9221-9

Cheng, H.-I. (2013). “A wobbly bed still stands on three legs”: On Chinese immigrant women’s experiences with ethnic community. Women & Language, 36, 7–25.

Choi, Y., Park, M., Noh, S., Lee, J. P., & Takeuchi, D. (2020). Asian American mental health: Longitudinal trend and explanatory factors among young Filipino- and Korean Americans. SSM – Population Health, 10. https://doi.org/10.1016/j.ssmph.2020.100542

Cohen, J. (1998). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum.

Congressional Asian Pacific American Caucus. (2020, February 26). As coronavirus fears incite violence, CAPAC members urge colleagues to not stoke xenophobia. https://capac-chu.house.gov/press-release/coronavirus-fears-incite-violence-capac-members-urge-colleagues-not-stoke-xenophobia

Connor, K. M., & Davidson, J. R. T. (2003). Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety, 18(2), 76–82. https://doi.org/10.1002/da.10113

Cordova, M. J., Riba, M. B., & Spiegel, D. (2017). Post-traumatic stress disorder and cancer. The Lancet Psychiatry, 4(4), 330–338. https://doi.org/10.1016/S2215-0366(17)30014-7

DeVitre, Z., & Pan, D. (2020). Asian American values and attitudes towards seeking mental health services. Journal of Asia Pacific Counseling, 10(1), 15–26. https://doi.org/10.18401/2020.10.1.2

Durkin, J., & Joseph, S. (2009). Growth following adversity and its relation with subjective well-being and psychological well-being. Journal of Loss and Trauma, 14(3), 228–234.
https://doi.org/10.1080/15325020802540561

Edmondson, D., Chaudoir, S. R., Mills, M. A., Park, C. L., Holub, J., & Bartkowiak, J. M. (2011). From shattered assumptions to weakened worldviews: Trauma symptoms signal anxiety buffer disruption. Journal of Loss and Trauma, 16(4), 358–385. https://doi.org/10.1080/15325024.2011.572030

Edwards, L. M., & Romero, A. J. (2008). Coping with discrimination among Mexican descent adolescents. Hispanic Journal of Behavioral Sciences, 30(1), 24–39. https://doi.org/10.1177/0739986307311431

Erikson, E. H. (1968). Identity: Youth and crisis. W. W. Norton.

Frazier, P. A., Tix, A. P., & Barron, K. E. (2004). Testing moderator and mediator effects in counseling psychology research. Journal of Counseling Psychology, 51(1), 115–134. https://doi.org/10.1037/0022-0167.51.1.115

Gee, G. C., Spencer, M., Chen, J., Yip, T., & Takeuchi, D. T. (2007). The association between self-reported racial discrimination and 12-month DSM-IV mental disorders among Asian Americans nationwide. Social Science & Medicine, 64(10), 1984–1996. https://doi.org/10.1016/j.socscimed.2007.02.013

Hayes, A. F. (2018). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach (2nd ed.). Guilford.

Helgeson, V. S., Reynolds, K. A., & Tomich, P. L. (2006). A meta-analytic review of benefit finding and growth. Journal of Consulting and Clinical Psychology, 74(5), 797–816. https://doi.org/10.1037/0022-006X.74.5.797

Hwang, W.-C., & Goto, S. (2008). The impact of perceived racial discrimination on the mental health of Asian American and Latino college students. Cultural Diversity and Ethnic Minority Psychology, 14(4), 326–335. https://doi.org/10.1037/1099-9809.14.4.326

Inman, A. G., & Yeh, C. J. (2007). Asian American stress and coping. In F. T. L. Leong, A. G. Inman, A. Ebreo, L. H. Yang, L. Kinoshita, & M. Fu (Eds.), Handbook of Asian American psychology (2nd ed., pp. 323–340). SAGE.

Iwamoto, D. K., & Liu, W. M. (2010). The impact of racial identity, ethnic identity, Asian values, and race-related stress on Asian Americans and Asian international college students’ psychological well-being. Journal of Counseling Psychology, 57(1), 79–91. https://doi.org/10.1037/a0017393

Janoff-Bulman, R. (2004). Posttraumatic growth: Three explanatory models. Psychological Inquiry, 15(1), 30–34.

Jeung, R., & Nham, K. (2020). Incidents of coronavirus-related discrimination. Asian Pacific Policy & Planning Council. http://www.asianpacificpolicyandplanningcouncil.org/wp-content/uploads/STOP_AAPI_HATE_MONTHLY_REPORT_4_23_20.pdf

Kim, J., & Kim, H. (2013). The experience of acculturative stress-related growth from immigrants’ perspectives. International Journal of Qualitative Studies on Health and Well-Being, 8(1).
https://doi.org/10.3402/qhw.v8i0.21355

Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer.

Le, D. L., & Ahn, S. (2011). Racial discrimination and Asian mental health: A meta-analysis. The Counseling Psychologist, 39(3), 463–489. https://doi.org/10.1177/0011000010381791

Lee, R. M. (2003). Do ethnic identity and other-group orientation protect against discrimination for Asian Americans? Journal of Counseling Psychology, 50(2), 133–141. https://doi.org/10.1037/0022-0167.50.2.133

Lee, R. M. (2005). Resilience against discrimination: Ethnic identity and other-group orientation as protective factors for Korean Americans. Journal of Counseling Psychology, 52(1), 36–44.
https://doi.org/10.1037/0022-0167-52.1.36

Lee, R. M., & Davis, C., III. (2000). Cultural orientation, past multicultural experience, and a sense of belonging on campus for Asian American college students. Journal of College Student Development, 41(1), 110–115.

Lee, R. M., & Yoo, H. C. (2004). Structure and measurement of ethnic identity for Asian American college students. Journal of Counseling Psychology, 51(2), 263–269. https://doi.org/10.1037/0022-0167.51.2.263

Leong, F., Park, Y. S., & Kalibatseva, Z. (2013). Disentangling immigrant status in mental health: Psychological protective and risk factors among Latino and Asian American immigrants. American Journal of Orthopsychiatry, 83(2–3), 361–371. http://doi.org/10.1111/ajop.12020

Liang, C. T. H., & Fassinger, R. E. (2008). The role of collective self-esteem for Asian Americans experiencing racism-related stress: A test of moderator and mediator hypotheses. Cultural Diversity and Ethnic Minority Psychology, 14(1), 19–28. https://doi.org/10.1037/1099-9809.14.1.19

Lieber, E., Chin, D., Nihira, K., & Mink, I. T. (2001). Holding on and letting go: Identity and acculturation among Chinese immigrants. Cultural Diversity and Ethnic Minority Psychology, 7(3), 247–261. https://doi.org/10.1037/1099-9809.7.3.247

Lim, J., & Ashing-Giwa, K. T. (2013). Is family functioning and communication associated with health-related quality of life for Chinese- and Korean-American breast cancer survivors? Quality of Life Research, 22, 1319–1329. https://doi.org/10.1007/s11136-012-0247-y

Linley, P. A., & Joseph, S. (2004). Positive change following trauma and adversity: A review. Journal of Traumatic Stress, 17(1), 11–21. https://doi.org/10.1023/B:JOTS.0000014671.27856.7e

Litam, S. D. A. (2020). “Take your Kung Flu back to Wuhan”: Counseling Asians, Asian Americans, and Pacific Islanders with race-based trauma related to COVID-19. The Professional Counselor, 10(2), 144–156. https://doi.org/10.15241/sdal.10.2.144

Litam, S. D. A., & Hipolito-Delgado, C. P. (2021). When being “essential” illuminates disparities: Counseling clients affected by COVID-19. Journal of Counseling & Development, 99(1), 3–10.
https://doi.org/10.1002/jcad.12349

Litam, S. D. A., & Oh, S. (in press). Effects of COVID-19 racial discrimination on depression and life satisfaction among young, middle, and older Chinese Americans. Adultspan Journal.

Litam, S. D. A., & Oh, S. (2020). Ethnic identity and coping strategies as moderators of COVID-19 racial discrimination experiences among Chinese Americans. Counseling Outcome Research and Evaluation. https://doi.org/10.1080/21501378.2020.1814138

Miller, C. T., & Kaiser, C. R. (2001). A theoretical perspective on coping with stigma. Journal of Social Issues, 57(1), 73–92. https://doi.org/10.1111/0022-4537.00202

Miller, C. T., & Major, B. (2000). Coping with stigma and prejudice. In T. F. Heatherton, R. E. Kleck, M. R. Hebl, & J. G. Hull (Eds.), The social psychology of stigma (pp. 243–272). Guilford.

Mongelli, F., Perrone, D., Balducci, J., Sacchetti, A., Ferrari, S., Mattei, G., & Galeazzi, G. M. (2019). Minority stress and mental health among LGBT populations: An update on the evidence. Minerva Psychiatrica, 60(1), 27–50. https://doi.org/10.23736/S0391-1772.18.01995-7

Mossakowski, K. N. (2003). Coping with perceived discrimination: Does ethnic identity protect mental health? Journal of Health and Social Behavior, 44(3), 318–331. https://doi.org/10.2307/1519782

Nadal, K. L., Wong, Y., Sriken, J., Griffin, K., & Fujii-Doe, W. (2015). Racial microaggressions and Asian Americans: An exploratory study on within-group differences and mental health. Asian American Journal of Psychology, 6(2), 136–144. https://doi.org/10.1037/a0038058

Noh, S., & Kaspar, V. (2003). Perceived discrimination and depression: Moderating effects of coping, acculturation, and ethnic support. American Journal of Public Health, 93(2), 232–238. https://doi.org/10.2105/ajph.93.2.232

Nolen-Hoeksema, S., & Davis, C. G. (2004). Theoretical and methodological issues in the assessment and interpretation of posttraumatic growth. Psychological Inquiry, 15, 60–64.

O’Rourke, N., & Hatcher, L. (2013). A step-by-step approach to using SAS for factor analysis and structural equation modeling (2nd ed.). SAS Press.

Osborn, J. W. (2013). Best practices in data cleaning: A complete guide to everything you need to do before and after collecting your data. SAGE.

Park, C. L., Cohen, L. H., & Murch, R. L. (1996). Assessment and prediction of stress-related growth. Journal of Personality, 64(1), 71–105. https://doi.org/10.1111/j.1467-6494.1996.tb00815.x

Park, C. L., & Fenster, J. R. (2004). Stress-related growth: Predictors of occurrence and correlates with psychological adjustment. Journal of Social and Clinical Psychology, 23(2), 195–215. https://doi.org/10.1521/jscp.23.2.195.31019

Phinney, J. S. (1990). Ethnic identity in adolescents and adults: Review of research. Psychological Bulletin, 108(3), 499–514. https://doi.org/10.1037/0033-2909.108.3.499

Phinney, J. S. (1992). The Multigroup Ethnic Identity Measure: A new scale for use with diverse groups. Journal of Adolescent Research, 7(2), 156–176. https://doi.org/10.1177/074355489272003

Phinney, J. S. (2003). Ethnic identity and acculturation. In K. M. Chun, P. B. Organista, & G. Marin (Eds.), Acculturation: Advances in theory, measurement, and applied research (pp. 63–82). American Psychological Association.

Pokhrel, P., & Herzog, T. A. (2014). Historical trauma and substance use among Native Hawaiian college students. American Journal of Health Behavior, 38(3), 420–429. https://doi.org/10.5993/AJHB.38.3.11

Prati, G., & Pietrantoni, L. (2009). Optimism, social support, and coping strategies as factors contributing to posttraumatic growth: A meta-analysis. Journal of Loss and Trauma, 14(5), 364–388.
https://doi.org/10.1080/15325020902724271

Preacher, K. J., Rucker, D. D., & Hayes, A. F. (2007). Addressing moderated mediation hypothesis: Theory, methods, and prescriptions. Multivariate Behavioral Research, 42(1), 185–227.
https://doi.org/10.1080/002731707001341316

Ratts, M. J., Singh, A. A., Nassar-McMillan, S., Butler, S. K., & McCullough, J. R. (2016). Multicultural and Social Justice Counseling Competencies: Guidelines for the counseling profession. Journal of Multicultural Counseling and Development, 44(1), 28–48. https://doi.org/10.1002/jmcd.12035

Rzeszutek, M., & Gruszczyńska, E. (2018). Paradoxical effect of social support among people living with HIV: A diary study investigating the buffering hypothesis. Journal of Psychosomatic Research, 109, 25–31. https://doi.org/10.1016/j.jpsychores.2018.03.006

Sue, D. W., Sue, D., Neville, H. A., & Smith, L. (2019). Counseling the culturally diverse: Theory and practice (8th ed.). Wiley.

Tabachnick, B. G., & Fidell, L. S. (2019). Using multivariate statistics (7th ed.). Pearson.

Tajfel, H., & Turner, J. C. (1979). An integrative theory of intergroup conflict. In W. G. Austin & S. Worchel (Eds.), The social psychology of intergroup relations. Brooks Cole.

Tedeschi, R. G., & Calhoun, L. G. (1995). Trauma and transformation: Growing in the aftermath of suffering. SAGE.

Tedeschi, R. G., & Calhoun, L. G. (1996). The posttraumatic growth inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9(3), 455–471. https://doi.org/10.1007/BF02103658

Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundation and empirical evidence. Psychological Inquiry, 15(1), 1–18. https://doi.org/10.1207/s15327965pli1501_01

Turner, J. C., Hogg, M. A., Oakes, P. J., Reicher, S. D., & Wetherell, M. S. (1987). Rediscovering the social group: A self-categorization theory. Basil Blackwell.

Tweed, R. G., & Conway, L. G., III. (2006). Coping strategies and culturally influenced beliefs about the world. In P. T. P. Wong & L. C. J. Wong (Eds.), Handbook of multicultural perspectives on stress and coping (pp. 133–153). Springer.

Vasquez, C., Valiente, C., García, F. E., Contreras, A., Peinado, V., Trucharte, A., & Bentall, R. P. (2021). Post-traumatic growth and stress-related responses during the COVID-19 pandemic in a national representative simple: The role of positive core beliefs about the world and others. Journal of Happiness Studies. https://doi.org/10.1007/s10902-020-00352-3

Wagnild, G. M., & Young, H. M. (1993). Development and psychometric evaluation of the Resilience Scale. Journal of Nursing Measurement, 1(2), 165–178.

Wei, M., Heppner, P. P., Ku, T.-Y., & Liao, K. Y.-H. (2010). Racial discrimination stress, coping, and depressive symptoms among Asian Americans: A moderation analysis. Asian American Journal of Psychology, 1(2), 136–150. https://doi.org/10.1037/a0020157

Wei, M., Wang, K. T., Heppner, P. P., & Du, Y. (2012). Ethnic and mainstream social connectedness, perceived racial discrimination, and posttraumatic stress symptoms. Journal of Counseling Psychology, 59(3), 486–493. https://doi.org/10.1037/a0028000

Wen, J., Aston, J., Liu, X., & Ying, T. (2020). Effects of misleading media coverage on public health crisis: A case of the 2019 novel coronavirus outbreak in China. An International Journal of Tourism and Hospitality Research, 31(2), 331–336. https://doi.org/10.1080/13032917.2020.1730621

Wong, G., Derthick, A. O., David, E. J. R., Saw, A., & Okazaki, S. (2014). The what, the why, and the how: A review of racial microaggressions research in psychology. Race and Social Problems, 6, 181–200. https://doi.org/10.1007/s12552-013-9107-9

Wong, Y. J., Kim, S.-H., & Tran, K. K. (2010). Asian Americans’ adherence to Asian values, attributions about depression, and coping strategies. Cultural Diversity and Ethnic Minority Psychology, 16(1), 1–8. https://doi.org/10.1037/a0015045

Yang, A. (2014). Themes in the career development of 1.5-generation Hmong American women. Journal of Career Development, 41(5), 402–425. https://doi.org/10.1177/0894845313507775

Yeh, C. J., Arora, A. K., & Wu, K. A. (2006). A new theoretical model of collectivistic coping. In P. T. P. Wong & L. C. J. Wong (Eds.), Handbook of multicultural perspectives on stress and coping: International and cultural psychology series (pp. 55–72). Springer.

Yip, T., & Fuligni, A. J. (2002). Daily variation in ethnic identity, ethnic behaviors, and psychological well-being among American adolescents of Chinese descent. Child Development, 73(5), 1557–1572. https://doi.org/10.1111/1467-8624.00490

Yip, T., Wang, Y., Mootoo, C., & Mirpuri, S. (2019). Moderating the association between discrimination and adjustment: A meta-analysis of ethnic/racial identity. Developmental Psychology, 55(6), 1274–1298. https://doi.org/10.1037/dev0000708

Yoo, H. C., Steger, M. F., & Lee, R. M. (2010). Validation of the Subtle and Blatant Racism Scale for Asian American College Students (SABRA-A2). Cultural Diversity and Ethnic Minority Psychology, 16(3), 323–334. https://doi.org/10.1037/a0018674

 

Stacey Diane Arañez Litam, PhD, NCC, CCMHC, LPCC-S, is an assistant professor at Cleveland State University. Seungbin Oh, PhD, NCC, LPC, is an assistant professor at Merrimack College. Catherine Chang, PhD, NCC, LPC, CPCS, is a professor at Georgia State University. Correspondence may be addressed to Stacey Litam, 2121 Euclid Ave., Cleveland, OH 44115, s.litam@csuohio.edu.

Mental Health Equity of Filipino Communities in COVID-19: A Framework for Practice and Advocacy

Christian D. Chan, Stacey Diane Arañez Litam

 

The emergence and global spread of COVID-19 precipitated a massive public health crisis combined with multiple incidents of racial discrimination and violence toward Asian American and Pacific Islander (AAPI) communities. Although East Asian communities are more frequently targeted for instances of pandemic-related racial discrimination, multiple disparities converge upon Filipino communities that affect their access to mental health care in light of COVID-19. This article empowers professional counselors to support the Filipino community by addressing three main areas: (a) describing how COVID-19 contributes to racial microaggressions and institutional racism toward Filipino communities; (b) underscoring how COVID-19 exacerbates exposure to stressors and disparities that influence help-seeking behaviors and utilization of counseling among Filipinos; and (c) outlining how professional counselors can promote racial socialization, outreach, and mental health equity with Filipino communities to mitigate the effects of COVID-19.

Keywords: Asian American, Filipino, mental health equity, COVID-19, discrimination

 

     Asian Americans represent the fastest-growing ethnic group in the United States (Budiman et al., 2019). Following the global outbreak of COVID-19, many Asian Americans and Pacific Islanders (AAPIs) have experienced a substantial increase in race-based hate incidents. These incidents of racial discrimination have included verbal harassment, physical attacks, and discrimination against Asian-owned businesses (Jeung & Nham, 2020), which multiply the harmful effects on psychological well-being and life satisfaction among AAPIs (Litam & Oh, 2020). According to Pew Research Center trends (Ruiz et al., 2020), about three in 10 Asian adults reported they experienced racial discrimination since the outbreak began. Proliferation of anti-Chinese and xenophobic hate speech from political leaders, news outlets, and social media, which touted COVID-19 as the “Chinese virus,” further exacerbate instances of race-based discrimination (U.S. Department of Justice, 2020) and echo the Yellow Peril discourse from the late 19th century (Litam, 2020; Poon, 2020).

Although the community is often aggregated, Asian Americans are not a monolithic entity (Choi et al., 2017; Jones-Smith, 2019; Sue et al., 2019). The term Asian American encompasses over 40 distinct subgroups, each with distinct languages, cultures, beliefs, and migration histories (Pew Research Center, 2013; Sue et al., 2019). It is no surprise, therefore, that specific ethnic subgroups would be more affected by the pandemic than others. For example, instances of COVID-19–related racial discrimination disproportionately affect East Asian communities, specifically Chinese migrants and Chinese Americans. An analysis of nearly 1,500 reports of anti-Asian hate incidents indicated approximately 40% of Chinese individuals reported experiences of discrimination as compared to 16% of Korean individuals and 5.5% of Filipinos (Jeung & Nham, 2020). Although Chinese individuals disproportionately experience overt forms of COVID-19–related discrimination, Filipino migrants and Filipino Americans are not immune to the deleterious effects of the pandemic.

With over 4 million people of Filipino descent residing in the United States (Asian Journal Press, 2018), it is of paramount importance for professional counselors to recognize how the Filipino American experience may compound with additional COVID-19 exposure and related stressors in unique ways that distinctively impact their experiences of stress and mental health. The current article identifies how the racialized climate of COVID-19 influences Filipino-specific microaggressions and the presence of systemic and institutional racism toward Filipino communities. The ways in which COVID-19 exacerbates existing racial disparities across social determinants of health, help-seeking behaviors, and utilization of counseling services are described. Finally, the implications for counseling practice and advocacy are presented in ways that can embolden professional counselors to promote racial socialization, outreach, and health equity with Filipino communities to mitigate the effects of COVID-19.

Health Disparities Among Filipino Americans

The unprecedented emergence of COVID-19 has affected the global community. As of January 5, 2021, a total of 21,382,296 cases were confirmed and 362,972 deaths had been reported in the United States (Worldometer, n.d.). Although information about how racial and ethnic groups are affected by the pandemic is forthcoming, emerging data suggests that specific groups are disproportionately affected. Professional counselors must be prepared to support communities that may be more vulnerable to pandemic-related stress and face challenges related to medical and mental health care access because of intersecting marginalized identities, such as age, race, ethnicity, gender identity, sexual identity, social class, and migration history (Chan & Henesy, 2018; Chan et al., 2019; Litam & Hipolito-Delgado, 2021). For example, the AAPI population may be especially in need of mental health support because of ongoing xenophobic sentiments from political leaders that combine with intergenerational trauma, racial discrimination, and racial trauma (Litam, 2020).

Underutilization of Mental Health Services
     Compared to other Asian American subgroups, Filipinos are the least likely to seek professional mental health services. In a study of 2,230 Filipinos, approximately 73% had never used any type of mental health service and only 17% sought help from friends, community members, peers, and religious or spiritual leaders (Gong et al., 2003). Since the Gong et al. (2003) study, a multitude of researchers have documented the persistent disparity of mental health usage and unfavorable attitudes toward professional help-seeking among Filipinos (David & Nadal, 2013; David et al., 2019; Nadal, 2021; Tuazon et al., 2019), despite high rates of psychological distress (Martinez et al., 2020).

     The experiences of Filipino communities uniquely influence aspects of mental health and wellness. Compared to other subgroups of Asian Americans, Filipino Americans with post-traumatic stress experiences tend to exhibit poorer health (Kim et al., 2012; Klest et al., 2013), and report higher rates of racial discrimination (Li, 2014). As a subgroup, Filipino Americans present to mental health counseling settings with high rates of depression, suicide, HIV, unintended pregnancy, eating disorders, and drug use (David et al., 2017; Klest et al., 2013; Nadal, 2000, 2021). Compared to other Asian subgroups, Filipinos may experience lower social class and employment statuses, which may increase the prevalence of mental health issues (Araneta, 1993). Among Filipinos, intergenerational cultural conflicts and experiences of racial discrimination were identified as significant contributors to depression and suicidal ideation (Choi et al., 2020). The underutilization of professional mental health services and help-seeking among Filipino communities is unusual because of their familiarity with Western notions, systems, and institutions, which surface as traits that are typically associated with mental health help-seeking within the broader AAPI community (Abe-Kim et al., 2002, 2004; Shea & Yeh, 2008).

Distinct Experiences of Oppression
     Aspects of Filipino history are characterized by colonization, oppression, and intergenerational racial trauma (David & Nadal, 2013) and have been rewritten by White voices in ways that communicate how America saved the Philippines from Spanish rule through colonization (Ocampo, 2016). These sentiments remain deeply entrenched within the mindset of many Filipinos in the form of colonial mentality (David & Nadal, 2013; Tuazon et al., 2019). Colonial mentality refers to the socialized and oppressive mindset characterized by beliefs about the superiority of American values and denigration of Filipino culture and self (David & Okazaki, 2006a, 2006b). Colonial mentality is the insidious aftermath galvanized through years of intergenerational trauma, U.S. occupation, and socialization under White supremacy (David et al., 2017). Professional counselors must recognize the interplay between colonial mentality and the mental health and well-being of Filipino clients to best support this unique population.

The internalized experiences of oppression perpetuate the denigration of Filipinos by Filipinos as a result of the internalized anti-Black sentiments and notions of White supremacy that remain at the forefront of American history (Ocampo, 2016). The Filipino experience is one that is characterized by forms of discrimination by individuals who reside both within and outside of the Filipino community (Nadal, 2021). For example, Filipinos who espouse a colonial mentality disparage those with Indigenous Filipino traits (i.e., dark skin and textured hair) as unattractive, undesirable, and worthy of shame (Angan, 2013; David, 2020; Mendoza, 2014). Filipinos also experience a sense of otherness within the AAPI community and from other communities of color because their history, culture, and phenotype combine in ways that “break the rules of race” (Ocampo, 2016, p. 13). Although Filipinos are sometimes confused with individuals from Chinese communities, they are not typically perceived as Asian or East Asian (Lee, 2020) and are often mistaken for Black or Latinx (Ocampo, 2016; Sanchez & Gaw, 2007). These pervasive experiences render the Filipino identity invisible (Nadal, 2021). Ultimately, Filipinos remain among the most mislabeled and culturally marginalized of Asian Americans (Sanchez & Gaw, 2007). Professional counselors who work with Filipino clients must obtain a deeper understanding of how these unique experiences of invisibility and colonial mentality continue to affect the minds and the worldviews of Filipinos and Filipino Americans.

Risk Factors for COVID-19 Exposure
     The burgeoning rate of COVID-19 cases has devastated hospitals and medical settings. The overwhelming strain faced by medical communities uniquely affects Filipino migrants and Filipino Americans who are overrepresented in health care and disproportionately at risk of COVID-19 exposure (National Nurses United, 2020). The overrepresentation of Filipinos in health care, particularly within the nursing profession, is directly tied to the history of U.S. colonization. Following the U.S. occupation of the Philippines from 1899 to 1946, the Filipino zeitgeist became imbued with profound cultural notions of American superiority and affinity for Westernized attitudes, behaviors, and values (David et al., 2017). For example, the introduction of the American nursing curricula by U.S. Army personnel during the Spanish-American war (McFarling, 2020) instilled pervasive cultural influences that positioned the nursing profession as a viable strategy to escape political and economic instability in pursuit of a better life in the United States (Choy, 2003). These cultural notions have culminated to make the Philippines the leading exporter of nurses in the world (Choy, 2003; Espiritu, 2016). Of the immigrant health care workers across the United States, an estimated 28% of registered nurses, 4% of physicians and surgeons, and 12% of home health aides are Filipinos (Batalova, 2020). About 150,000 registered nurses in the United States are Filipino, equating to about 4% of the overall nursing population (McFarling, 2020; National Nurses United, 2020). According to the National Nurses United (2020) report, 31.5% of deaths among registered nurses and 54% of deaths among registered nurses of color were Filipinos. Based on these statistics, Filipinos face disproportionate exposure to pandemic-related stressors and death that may increase the risk for mental health issues.

Individuals of Filipino descent may also face significant COVID-19–related challenges, as they are predisposed to several health conditions that have been linked with poorer treatment prognosis and outcomes (Ghimire et al., 2018; Maxwell et al., 2012). Compared to other racial and ethnic subgroups, Filipinos residing in California had higher rates of type II diabetes, asthma, and cardiovascular disease (Adia et al., 2020). High rates of hypertension, cholesterol, and diabetes were also noted in studies of Filipino Americans residing in the greater Philadelphia region (Bhimla et al., 2017) and in Las Vegas, Nevada (Ghimire et al., 2018). One study of Filipinos residing in the New York metropolitan area indicated rates of obesity significantly increased the longer Filipino immigrants resided in the United States (Afable et al., 2016). The Centers for Disease Control and Prevention (2021) associated each of these underlying medical conditions with a greater likelihood for hospitalization, intensive care, use of a ventilator, and increased mortality. Filipino Americans also tend to report lower social class and employment statuses as compared to other Asian Americans, which may contribute to higher rates of mental health issues and create barriers to health care access (Adia et al., 2020; Sue et al., 2019).

Cultural Barriers to Professional Mental Health Services
     Filipinos face culturally rooted barriers to seeking professional mental health services that may include fears related to reputation, endorsement of fatalistic attitudes, religiousness, communication barriers, and lack of culturally competent services (Gong et al., 2003; Nadal, 2021; Pacquiao, 2004). The presence of mental illness stigma is also deeply entrenched within Filipino communities (Appel et al., 2011; Augsberger et al., 2015; Tuazon et al., 2019). In many traditional Filipino families, mental illness is mitigated by addressing personal and emotional problems with family and close friends, and through faith in God (David & Nadal, 2013). Rejection of mental illness is based on the belief that individuals who receive counseling or therapy are crazy, dangerous, and unpredictable (de Torres, 2002; Nadal, 2021).

Connection and Kinship
     Given the central prominence of family, it is no surprise that Filipino individuals’ mental health begins to suffer when their connection to community and kinship is compromised. Although relatively few studies on Filipino mental health exist, Filipinos and Filipino Americans consistently report family-related issues as among the most stressful. In one study of Filipino and Korean families in the Midwest (N = 1,574), the presence of intergenerational family conflict significantly contributed to an increase in depressive symptoms and suicidal ideation (Choi et al., 2020). In another study of Filipino Americans, quality time with family, friends, and community was identified as an important factor in mitigating the effects of depression (Edman & Johnson, 1999). The centralized role of Filipino families uniquely combines with a group mentality in ways that may additionally hinder rates of professional help-seeking.

Hiya and Amor Propio
     Notions of hiya and amor propio each represent culturally specific barriers to seeking mental health care. According to Gong and colleagues (2003), hiya and amor propio are related to the East Asian notions of saving face. While hiya emphasizes the more extensive experience of shame that arises from fear of losing face, amor propio is associated with concepts of self-esteem linked to the desire to maintain social acceptance. A loss of amor propio would result in a loss of face and may compromise the cherished position of community acceptance (Gong et al., 2003). Filipino Americans may thus avoid seeking professional mental health services because of combined feelings of shame (hiya) linked to beliefs that one has failed or is unable to overcome their problems independently, and fears of losing social positioning within one’s community (amor propio). To experience amor propio would put a Filipino—or worse, their family—at risk for tsismis, or gossip. Indeed, avoiding behaviors that may lead others within the Filipino community to engage in tsismis about the client or their family is a significant factor that guides choices and behaviors. Engaging in behaviors that result in one’s family becoming the focus of tsismis is considered highly shameful and reprehensible among Filipino communities.

Bahala Na
     The Tagalog term bahala na refers to the sense of optimistic fatalism that characterizes the shared experiences of many Filipinos and Filipino Americans. Bahala na can be evidenced through Filipino cultural expectations to endure emotional problems and avoid discussion of personal issues. This core attitude may have deleterious effects on mental health and help-seeking, as many Filipinos are socialized to deny or minimize stressful experiences or to simply endure emotional problems (Araneta, 1993; Sanchez & Gaw, 2007). A qualitative analysis of 33 interviews and 18 focus groups of Filipino Americans indicated bahala na may combine with religious beliefs to create additional barriers to addressing mental health problems (Javier et al., 2014). For example, virtuous and religious Filipinos and Filipino Americans may endorse bahala na attitudes by believing their higher power has instilled purposeful challenges that can be overcome by sufficient faith and endurance (Javier et al., 2014).

Hindi Ibang Tao
     Moreover, many Filipinos and Filipino Americans demonstrate hesitance to trust individuals who are considered outsiders. When interactions with those considered other cannot be avoided, traditional Filipinos tend to be reticent, conceal their real emotions, and avoid disclosure of personal thoughts, needs, and beliefs (Pasco et al., 2004). Filipino community members place a large value on in-group versus out-group members and largely prefer to seek support from helping professionals within the Filipino community, rather than from others outside of the group (Gong et al., 2003). Individuals who are hindi ibang tao (in Tagalog, “one of us”) are differentiated from those who are ibang tao (in Tagalog, “not one of us”), which influences interactions and amount of trust given to health care providers (Sanchez & Gaw, 2007). White counselors may be able to bridge the cultural gap with Filipino clients to become hindi ibang tao by exhibiting respect, approachability, and a willingness to consider the specific influences of Filipino history and the importance of family (Sanchez & Gaw, 2007). Professional counselors who overlook, minimize, or disregard these cultural values risk higher rates of early termination and may experience their Filipino clients as exhibiting little emotion (Nadal, 2021). Filipino clients who are not yet comfortable with professional counselors may interact in a polite, yet superficial manner because culturally responsive relationships and trust have not been developed (Gong et al., 2003; Pasco et al., 2004; Tuazon et al., 2019).

Pakikisama and Kapwa
     Another Filipino cultural barrier is pakikisama, or the notion that when one belongs to a group, one should be wholly dedicated to pleasing the group (Bautista, 1999; Nadal, 2021). Filipino core values extend beyond the general notion of collectivism and include kapwa, an Indigenous worldview in which the self is not distinguished from others (David et al., 2017; Enriquez, 2010). Thus, Filipinos do not solely act in ways that benefit the group; they are also expected to make decisions that please other group members, even at the expense of their own desires, needs, or mental health (Nadal, 2021). The cultural notions of pakikisama and kapwa interplay with amor propio in ways that have detrimental effects on Filipinos in dire need of mental health support. For example, a second-generation Filipino American may recognize that their suicidal thoughts and experiences of depression may be worthy of mental health support, but recognition of cultural mistrust toward those deemed other may risk their family’s social acceptance (amor propio). Risking the family’s social acceptance could ultimately violate group wishes (pakikisama) and may subject their family to stigma and gossip (tsismis).

Implications for Practice and Advocacy in Professional Counseling

The COVID-19 pandemic and increased visibility to discrimination against Asian Americans illuminates the importance of addressing the presence of mental health barriers among Filipino communities. Filipino communities face complex barriers rooted in colonialism, racism, and colorism that negatively affect their overall mental health (David & Nadal, 2013; Tuazon et al., 2019; Woo et al., 2020). The combination of educational, health, and welfare disparities culminate in poorer health outcomes for Filipino American communities compared to other ethnic Asian groups (Adia et al., 2020). Many of these identifiable barriers and forces of oppression increase the racial trauma narratives incurred among Filipino communities (David et al., 2017; Klest et al., 2013); deny the impact of microaggressions and discrimination (Nadal et al., 2014); divest resources that support economic, educational, and social well-being (Nadal, 2021; Smith & Weinstock, 2019); and discourage the utilization of needed counseling spaces (Tuazon et al., 2019).

Cultivating cultural sensitivity in health care providers can buffer the psychological toll and emotional consequences of negative health care encounters for historically marginalized communities (Flynn et al., 2020), including Filipinos. Findings associated with health equity and help-seeking behaviors (e.g., Flynn et al., 2020; Ghimire et al., 2018) have significant ramifications for Filipino communities that face a litany of barriers to counseling services (Gong et al., 2003; Tuazon et al., 2019). In light of COVID-19, professional counselors are encouraged to employ culturally responsive interpersonal and systemic interventions that promote the sustainable mental health equity of Filipino communities.

Promoting Racial Socialization and Critical Consciousness
     Reducing barriers for mental health access is connected to protective factors, actions, and cultural capital instilled across generations of Filipino communities (David et al., 2017). Filipino communities draw from several generations of colonization, which continues to affect second-generation Filipinos living in the United States (David & Okazaki, 2006a, 2006b). Experiences of historical colonization, forced assimilation into other cultures, and the erasure of Filipino cultural values have resulted in a range of Eurocentrically biased and historically oppressive experiences (Choi et al., 2020; David & Nadal, 2013). These experiences have prepared Filipino communities, intergenerationally and collectively, to respond to experiences of discrimination in ways that preserve their cultural values (David et al., 2017). The preservation of Filipino cultural values across generations has bolstered a type of protective factor through racial socialization, where parents and families teach future generations of children about race and racism (Juang et al., 2017). Ultimately, preparing future generations of Filipinos to respond to racial oppression can protect cultural assets (David et al., 2017). In fact, a study by Woo and colleagues (2020) indicated Filipino parents who prepared their children to respond to racial discrimination prepared them for bias and strengthened their ethnic identity.

One strategy that professional counselors can use to infuse social justice in their work is to help Filipino clients raise their critical consciousness. Critical consciousness is an approach that helps clients to recognize the systemic factors contributing to their barriers with mental health utilization and mental health stressors (David et al., 2019; Diemer et al., 2016; Ratts & Greenleaf, 2018; Seider et al., 2020) and to feel empowered to take part in action (Ratts et al., 2016; Watts & Hipolito-Delgado, 2015). Professional counselors can raise Filipino clients’ critical consciousness by engaging in conversations about how the history of colonization, endorsement of colonial mentality, and systemic factors continue to marginalize Filipinos (David et al., 2019). Connecting critical consciousness to COVID-19, professional counselors can highlight how public anti-Asian discourse echoes centuries of oppression and leads to cultural mistrust of health care providers, particularly professional counselors (Litam, 2020; Ratts & Greenleaf, 2018; Tuazon et al., 2019). Similarly, professional counselors can raise the critical consciousness of Filipino clients by discussing the effects of race-based trauma and racial violence as a result of COVID-19 (Litam, 2020; Nadal, 2021). Including these topics during counseling can be instrumental for detecting the effects of race-based trauma, such as somatic symptoms, while grasping the manifestation of pandemic stress (Taylor et al., 2020). As health care providers focus predominantly on wellness, professional counselors play a significant part in deconstructing the connections and nuances among race-based traumatic stress and pandemic stress (Ratts & Greenleaf, 2018).

Additionally, professional counselors can raise the critical consciousness of Filipino clients by examining the intersection of underlying health disparities, Filipino core values, and overrepresentation of Filipinos working in health care positions during COVID-19 through a trauma-informed lens. Aligned with this perspective, professional counselors can identify and discuss how intergenerational trauma narratives may have persisted across generations of Filipino communities (David & Okazaki, 2006b; David et al., 2019; Nadal, 2021; Tuazon et al., 2019) in ways that have adverse effects on mental health. For example, professional counselors may support Filipino clients to critically reflect on how socialized messages from parents and elders with intergenerational trauma may have contributed to the internalization of colonial mentality. Professional counselors may also broach these cultural factors by promoting discussions within clients’ families and communities about the cultural preservation of Filipino identities (Choi et al., 2017, 2020; David et al., 2017).

Culturally Congruent Coping Responses Among Filipino Clients
     Professional counselors can help Filipino clients who seek counseling during COVID-19 by empowering them to engage in coping responses that cultivate their cultural assets and strengthen their ethnic identity (David et al., 2017, 2019; Woo et al., 2020). Before implementing these culturally sensitive strategies, professional counselors must reflect on whether they hold individualistic notions and Western attitudes about which coping responses are deemed helpful or unhelpful to mitigate the effects of racial discrimination (Oh et al., in press; Sue et al., 2019). Following experiences of racial discrimination and stress, Filipinos tend to use disengagement coping responses (Centeno & Fernandez, 2020; Tuason et al., 2007). Following an assessment of coping responses, professional counselors can support Filipino clients by reinforcing culturally responsive disengagement coping strategies, such as tiyaga (Tagalog for “patience and endurance”) and lakas ng loob (Tagalog for “inner strength and hardiness”), to promote resilience and demonstrate flexibility.

Given these central cultural values, professional counselors must be cautioned from solely using emotion-centered counseling strategies that center experiences of stress, racial trauma, or COVID-19–related discrimination (Litam, 2020). Instead, Filipino clients may benefit from interventions that draw from their cultural values of endurance (tiyaga) and inner strength (lakas ng loob) to refocus energy toward cultivating meaningful relationships and roles (David & Nadal, 2013; David et al., 2017). For example, Filipino clients who are concerned about the wellness of their community may experience a heightened sense of purpose and inner strength by reflecting on how their actions have already benefitted their families rather than focusing on their fears. Indeed, when stressful experiences occur, Filipinos have a long history of demonstrating resilience. Empowering Filipino clients to reflect on the historical ways that the Filipino community has evidenced resilience and inner strength may cultivate a strong sense of Filipino pride and strengthen ethnic identity as protective factors to mental health distress (Choi et al., 2020; David et al., 2019; Tuazon et al., 2019).

Filipinos may also benefit from engagement coping strategies, such as prayer, employing religious and spiritual resources, and responding with humor, to promote health and wellness (Nadal, 2021; Sanchez & Gaw, 2007). Counselors can help Filipino clients leverage engagement coping strategies by reflecting on existing responses to stress. Counselors may ask, “How have you intentionally responded to stressful events in the past?” and “How did these ways of coping impact your levels of stress?” Counselors can also demonstrate culturally sensitive strategies and lines of questioning that move from general, shared Filipino values to specific client experiences. For example, counselors can state: “Many Filipinos find peace of mind through prayer, religious practices, and humor. I’m wondering if this is true for you?” Because of the community orientation and collectivism embedded within Filipino culture, it may be helpful for counselors to elaborate on cultural contexts and relationships that inform coping strategies: “I am wondering how you may have seen some of these coping strategies in your home, family, or community. How might you have experienced a coping strategy like humor within your own community?” This statement communicates a familiarity with Filipino cultural values and creates an invitation for clients to explore their coping resources. 

Creating Outreach Initiatives and Partnerships
     For counselors placed in school and community settings, challenging the systemic effects of COVID-19 among Filipino communities necessitates community partnerships and integrated care settings to achieve health equity (Adia et al., 2019). Health equity initiatives call for two types of overarching efforts to sustain long-term benefits and changes. One aspect of health equity relates to developing community partnerships as a method to intentionally increase health literacy within the community (Guo et al., 2018). Increasing mental health literacy, including education about counseling services and a comprehensive approach to wellness, operates as a direct intervention to cultural and linguistic barriers that precede negative health care experiences (Flynn et al., 2020). Increasing mental health literacy in Filipino communities may also normalize the process of professional mental health services, challenge the cultural notion that those who seek mental health care are crazy, and offer strength-based language related to counseling services (Ghimire et al., 2018; Maxwell et al., 2012; Nadal, 2021). Expanding on recommendations by Tuazon and colleagues (2019), professional counselors can challenge the systemic effects of COVID-19 in Filipino communities by helping community stakeholders understand culturally responsive practices for seeking professional mental health services. Professional counselors employed in community settings can leverage opportunities to liaise with Filipino community organizations and leaders to increase the utilization of counseling services as a preventive method (Graham et al., 2018; Maxwell et al., 2012), especially in response to the increased mental health issues in Filipinos following COVID-19. Professional counselors employed in community settings are therefore uniquely positioned to broach cultural factors of colonialism and systemic racism while addressing the urgency of mental health services for Filipino communities during COVID-19 (Day-Vines et al., 2018, 2020).

Increasing Visibility of Filipino Counselors
     The second aspect of health equity initiatives focuses on increasing representation in the pipeline of providers. Although Flynn and colleagues (2020) documented the importance of culturally responsive practices to buffer negative health care experiences, public health scholars have generally identified that the representation of professional counselors is crucial for encouraging historically marginalized communities to seek services (Campbell, 2019; Graham et al., 2018; Griffith, 2018). According to Campbell (2019), historically marginalized clients are more likely to pursue services and demonstrate an openness to speak with professional counselors who are representative of their communities. In addition to increasing Filipino counselors and counselor educators in the pipeline (Tuazon et al., 2019), professional counselors can enact community-based initiatives that position Filipino leaders to support the larger Filipino community (Guo et al., 2018; Maxwell et al., 2012; Nadal, 2021). For example, professional counselors can train Filipino leaders and community members to share information about coping responses (e.g., mindfulness, yoga, and diaphragmatic breathing) that mitigate the deleterious effects of racism, colonialism, and COVID-19–related stress. Professional counselors can also work with community members to establish Filipino-led wellness groups that frame discussions about stress within the broader context of health and wellness. Assessing for previous assumptions about mental health literacy may be helpful to normalize group discussions about stress and mental health. As outreach initiatives and community partnerships are established within the context of COVID-19, professional counselors must consider how they develop marketing materials for counseling services that appropriately reflect the cultural and linguistic diversity of Filipinos and invite input from Filipino community leaders (Campbell, 2019; Graham et al., 2018).

Conclusion

The cumulative effects of colonialism and racism continue to influence the mental health and visibility of Filipino communities within the global crisis of COVID-19. Unlike other AAPI subgroups, experiences of pandemic-related distress in Filipinos are additionally compounded by their distinct history of colonization, cultural values, and low levels of help-seeking behaviors. Specific interventions for culturally responsive counseling and outreach for Filipino communities are critical (Choi et al., 2017; David & Nadal, 2013; David et al., 2017; Tuazon et al., 2019) and were outlined in this article. Professional counselors, especially those in community settings, have numerous opportunities to enact a systematic plan of action that integrates culture, health, and policy (Chan & Henesy, 2018; Nadal, 2021). These interventions illuminate a longstanding and never more urgent call to action for extending efforts and initiatives to increase the visibility of Filipino communities and support individuals of Filipino descent in counseling.

 

Conflict of Interest and Funding Disclosure
The authors reported no conflict of interest
or funding contributions for the development
of this manuscript.

 

References

Abe-Kim, J., Gong, F., & Takeuchi, D. (2004). Religiosity, spirituality, and help-seeking among Filipino Americans: Religious clergy or mental health professionals? Journal of Community Psychology, 32(6), 675–689. https://doi.org/10.1002/jcop.20026

Abe-Kim, J., Takeuchi, D. T., & Hwang, W.-C. (2002). Predictors of help seeking for emotional distress among Chinese Americans: Family matters. Journal of Consulting and Clinical Psychology, 70(5), 1186–1190.
https://doi.org/10.1037/0022-006X.70.5.1186

Adia, A. C., Nazareno, J., Operario, D., & Ponce, N. A. (2020). Health conditions, outcomes, and service access among Filipino, Vietnamese, Chinese, Japanese, and Korean adults in California, 2011–2017. American Journal of Public Health, 110(4), 520–526. https://doi.org/10.2105/AJPH.2019.305523

Adia, A. C., Ng, M. J., Quilantang, M. I., Restar, A. J., Hernandez, L. I., Imperial, R. H., Nazareno, J., & Operario, D. (2019). Collective coping strategies for HIV-related challenges among men who have sex with men in Manila, Philippines. AIDS Education and Prevention, 31(5), 479–490.
https://doi.org/10.1521/aeap.2019.31.5.479

Afable, A., Ursua, R., Wyatt, L. C., Aguilar, D., Kwon, S. C., Islam, N. S., & Trinh-Shevrin, C. (2016). Duration of US residence is associated with overweight risk in Filipino immigrants living in New York metro area. Family and Community Health, 39(1), 13–23. https://doi.org/10.1097/FCH.0000000000000086

Angan, J. (2013). Beyond the beach: The untold story of Boracay’s Ati tribe. GMA News Online. https://www.gmanet
work.com/news/lifestyle/artandculture/313920/beyond-the-beach-the-untold-story-of-boracay-s-ati-tribe/story

Appel, H. B., Huang, B., Ai, A. L., & Lin, C. J. (2011). Physical, behavioral, and mental health issues in Asian American women: Results from the National Latino Asian American Study. Journal of Women’s Health, 20(11), 1703–1711. https://doi.org/10.1089/jwh.2010.2726

Araneta, E. G. (1993). Psychiatric care of Filipino Americans. In A. C. Gaw (Ed.), Culture, Ethnicity, and Mental Illness (pp. 377–411). American Psychiatric Association.

Asian Journal Press. (2018). New census data shows more than four million Filipinos in the US. https://www.asian
journal.com/usa/dateline-usa/new-census-data-shows-more-than-four-million-filipinos-in-the-us

Augsberger, A., Yeung, A., Dougher, M., & Hahn, H. C. (2015). Factors influencing the underutilization of mental health services among Asian American women with a history of depression and suicide. BMC Health Services Research, 15(1), 1–11. https://doi.org/10.1186/s12913-015-1191-7

Batalova, J. (2020). Immigrant health-care workers in the United States. Migration Policy Institute. https://www.migrationpolicy.org/article/immigrant-health-care-workers-united-states-2018

Bautista, V. (1999). The Filipino Americans: From 1763 to the present: Their history, culture, and traditions. Bookhaus.

Bhimla, A., Yap, L., Lee, M., Seals, B., Aczon, H., & Ma, G. X. (2017). Addressing the health needs of high-risk Filipino Americans in the greater Philadelphia region. Journal of Community Health, 42(2), 269–277.
https://doi.org/10.1007/s10900-016-0252-0

Budiman, A., Cilluffo, A., & Ruiz, N. G. (2019). Key facts about Asian origin groups in the U.S. Pew Research Center. https://www.pewresearch.org/fact-tank/2019/05/22/key-facts-about-asian-origin-groups-in-the-u-s

Campbell, K. M. (2019). Race, gender, and health equity. Journal of Best Practices in Health Professions Diversity, 11(2), 155–157.

Centeno, R. P. R., & Fernandez, K. T. G. (2020). Effect of mindfulness on empathy and self-compassion: An adapted MBCT program on Filipino college students. Behavioral Sciences, 10(3), 1–15.
https://doi.org/10.3390/bs10030061

Centers for Disease Control and Prevention. (2021). People with certain medical conditions. Retrieved March 14, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fneed-extra-precautions%2Fgroups-at-higher-risk.html

Chan, C. D., & Henesy, R. K. (2018). Navigating intersectional approaches, methods, and interdisciplinarity to health equity in LGBTQ+ communities. Journal of LGBT Issues in Counseling, 12(4), 230–247.
https://doi.org/10.1080/15538605.2018.1526157

Chan, C. D., Henesy, R. K., & Erby, A. N. (2019). Toward praxis, promise, and futures of intersectionality in multimethod counseling research. Counseling Outcome Research and Evaluation, 10(1), 12–18.
https://doi.org/10.1080/21501378.2018.1562845

Choi, Y., Park, M., Lee, J. P., Kim, T. Y., & Tan, K. (2017). Culture and family process: Examination of culture-specific family process via development of new parenting measures among Filipino and Korean American families with adolescents. In Y. Choi & H. C. Hahm (Eds.), Asian American parenting: Family process and intervention (pp. 37–68). Springer. https://doi.org/10.1007/978-3-319-63136-3_3

Choi, Y., Park, M., Noh, S., Lee, J. P., & Takeuchi, D. (2020). Asian American mental health: Longitudinal trend and explanatory factors among young Filipino- and Korean Americans. SSM – Population Health, 10, 1–10. https://doi.org/10.1016/j.ssmph.2020.100542

Choy, C. C. (2003). Empire of care: Nursing and migration in Filipino American history. Duke University Press.

David, E. J. R. (2020). Addressing anti-Black microaggressions in Filipino families. Psychology Today. https://www.psychologytoday.com/us/blog/unseen-and-unheard/202006/addressing-anti-black-microaggressions-in-filipino-families-0

David, E. J. R., & Nadal, K. L. (2013). The colonial context of Filipino American immigrants’ psychological experiences. Cultural Diversity and Ethnic Minority Psychology, 19(3), 298–309.
https://doi.org/10.1037/a0032903

David, E. J. R., & Okazaki, S. (2006a). Colonial mentality: A review and recommendation for Filipino American psychology. Cultural Diversity and Ethnic Minority Psychology, 12(1), 1–16.
https://doi.org/10.1037/1099-9809.12.1.1

David, E. J. R., & Okazaki, S. (2006b). The Colonial Mentality Scale (CMS) for Filipino Americans: Scale construction and psychological implications. Journal of Counseling Psychology, 53(2), 241–252.
https://doi.org/10.1037/0022-0167.53.2.241

David, E. J. R., Sharma, D. K. B., & Petalio, J. (2017). Losing kapwa: Colonial legacies and the Filipino American family. Asian American Journal of Psychology, 8(1), 43–55. https://doi.org/10.1037/aap0000068

David, E. J. R., Schroeder, T. M., & Fernandez, J. (2019). Internalized racism: A systematic review of the psychological literature on racism’s most insidious consequence. Journal of Social Issues, 75(4), 1057–1086. https://doi.org/10.1111/josi.12350

Day-Vines, N. L., Booker Ammah, B., Steen, S., & Arnold, K. M. (2018). Getting comfortable with discomfort: Preparing counselor trainees to broach racial, ethnic, and cultural factors with clients during counseling. International Journal for the Advancement of Counselling, 40(2), 89–104.
https://doi.org/10.1007/s10447-017-9308-9

Day-Vines, N. L., Cluxton-Keller, F., Agorsor, C., Gubara, S., & Otabil, N. A. A. (2020). The multidimensional model of broaching behavior. Journal of Counseling & Development, 98(1), 107–118. https://doi.org/10.1002/jcad.12304

de Torres, S. (2002). Understanding persons of Philippine origin: A primer for rehabilitation service providers. Center for Institutional Rehabilitation Research Information and Exchange. http://cirrie-sphhp.webapps.buffalo.edu/culture/monographs/philippines.php

Diemer, M. A., Rapa, L. J., Voight, A. M., & McWhirter, E. H. (2016). Critical consciousness: A developmental approach to addressing marginalization and oppression. Child Development Perspectives, 10(4), 216–221. https://doi.org/10.1111/cdep.12193

Edman, J. L., & Johnson, R. C. (1999). Filipino American and Caucasian American beliefs about the causes and treatment of mental problems. Cultural Diversity and Ethnic Minority Psychology, 5(4), 380–386.
https://doi.org/10.1037/1099-9809.5.4.380

Enriquez, V. G. (2010). From colonial to liberation psychology: The Philippine experience (2nd ed.). University of the Philippines Press.

Espiritu, Y. L. (2016). Gender, migration, and work: Filipina health care professionals to the United States. In M. Zhou & A. C. Ocampo (Eds.), Contemporary Asian America: A multidisciplinary reader (3rd ed., pp. 236–256). New York University Press.

Flynn, P. M., Betancourt, H., Emerson, N. D., Nunez, E. I., & Nance, C. M. (2020). Health professional cultural competence reduces the psychological and behavioral impact of negative healthcare encounters. Cultural Diversity and Ethnic Minority Psychology, 26(3), 271–279. https://doi.org/10.1037/cdp0000295

Ghimire, S., Cheong, P., Sagadraca, L., Chien, L.-C., & Sy, F. S. (2018). A health needs assessment of the Filipino American community in the greater Las Vegas area. Health Equity, 2(1), 334–348.
https://doi.org/10.1089/heq.2018.0042

Gong, F., Gage, S.-J. L., & Tacata, L. A., Jr. (2003). Helpseeking behavior among Filipino Americans: A cultural analysis of face and language. Journal of Community Psychology, 31(5), 469–488.
https://doi.org/10.1002/jcop.10063

Graham, L. F., Scott, L., Lopeyok, E., Douglas, H., Gubrium, A., & Buchanan, D. (2018). Outreach strategies to recruit low-income African American men to participate in health promotion programs and research: Lessons from the Men of Color Health Awareness (MOCHA) project. American Journal of Men’s Health, 12(5), 1307–1316. https://doi.org/10.1177/1557988318768602

Griffith, D. M. (2018). “Centering the margins”: Moving equity to the center of men’s health research. American Journal of Men’s Health, 12(5), 1317–1327. https://doi.org/10.1177/1557988318773973

Guo, M., Quensell, M., Chang, A., Miyamura, J., & Sentell, T. (2018). Understanding of key obstetric quality terminology by Asian and Pacific Islander subgroups: Implications for patient engagement and health equity. Maternal and Child Health Journal, 22(11), 1543–1549. https://doi.org/10.1007/s10995-018-2597-8

Javier, J. R., Supan, J., Lansang, A., Beyer, W., Kubicek, K., & Palinkas, L. A. (2014). Preventing Filipino mental health disparities: Perspectives from adolescents, caregivers, providers, and advocates. Asian American Journal of Psychology, 5(4), 316–324. https://doi.org/10.1037/a0036479

Jeung, R., & Nham, K. (2020). Incidents of Coronavirus-related discrimination. Asian Pacific Policy & Planning Council. http://www.asianpacificpolicyandplanningcouncil.org/wp-content/uploads/STOP_AAPI_HATE_MONTHLY_REPORT_4_23_20.pdf

Jones-Smith, E. (2019). Culturally diverse counseling: Theory and practice. SAGE.

Juang, L. P., Yoo, H. C., & Atkin, A. (2017). A critical race perspective on an empirical review of Asian American parental racial-ethnic socialization. In Y. Choi & H. C. Hahm (Eds.), Asian American parenting: Family process and intervention (pp. 11–35). Springer. https://doi.org/10.1007/978-3-319-63136-3_2

Kim, G., Chiriboga, D. A., Bryant, A., Huang, C.-H., Crowther, M., & Ma, G. X. (2012). Self-rated mental health among Asian American adults: Association with psychiatric disorders. Asian American Journal of Psychology, 3(1), 44–52. https://doi.org/10.1037/a0024318BB

Klest, B., Freyd, J. J., Hampson, S. E., & Dubanoski, J. P. (2013). Trauma, socioeconomic resources, and self-rated health in an ethnically diverse adult cohort. Ethnicity & Health, 18(1), 97–113.
https://doi.org/10.1080/13557858.2012.700916

Li, M. (2014). Discrimination and psychiatric disorder among Asian American immigrants: A national analysis by subgroups. Journal of Immigrant and Minority Health, 16, 1157–1166.
https://doi.org/10.1007/s10903-013-9920-7

Litam, S. D. A. (2020). “Take your Kung-Flu back to Wuhan”: Counseling Asians, Asian Americans, and Pacific Islanders with race-based trauma related to COVID-19. The Professional Counselor, 10(2), 144–156.
https://doi.org/10.15241/sdal.10.2.144

Litam, S. D. A., & Hipolito-Delgado, C. P. (2021). When being “essential” illuminates disparities: Counseling clients affected by COVID-19. Journal of Counseling & Development, 99(1), 3–10. https://doi.org/10.1002/jcad.12349

Litam, S. D. A., & Oh, S. (2020). Ethnic identity and coping strategies as moderators of COVID-19 racial discrimination experiences among Chinese Americans. Counseling Outcome Research and Evaluation. Online publication. https://doi.org/10.1080/21501378.2020.1814138

Martinez, A. B., Co, M., Lau, J., & Brown, J. S. L. (2020). Filipino help-seeking for mental health problems and associated barriers and facilitators: A systematic review. Social Psychiatry and Psychiatric Epidemiology, 55, 1397–1413.  https://doi.org/10.1007/s00127-020-01937-2

Maxwell, A. E., Danao, L. L., Cayetano, R. T., Crespi, C. M., & Bastani, R. (2012). Evaluating the training of Filipino American community health advisors to disseminate colorectal cancer screening. Journal of Community Health, 37(6), 1218–1225. https://doi.org/10.1007/s10900-012-9557-9

McFarling, U. L. (2020). Nursing ranks are filled with Filipino Americans. The pandemic is taking an outsized toll on them. Stat. https://www.statnews.com/2020/04/28/coronavirus-taking-outsized-toll-on-filipino-american-nurses

Mendoza, R. L. (2014). The skin whitening industry in the Philippines. Journal of Public Health Policy, 35(2), 219–238. https://doi.org/10.1057/jphp.2013.50

Nadal, K. L. (2000). F/Pilipino American substance abuse: Sociocultural factors and methods of treatment. Journal of Alcohol and Drug Education, 46(2), 26–36.

Nadal, K. L. (2021). Filipino American psychology: A handbook of theory, research, and clinical practice (2nd ed.). Wiley.                          https://doi.org/10.1002/9781119677109

Nadal, K. L., Griffin, K. E., Wong, Y., Hamit, S., & Rasmus, M. (2014). The impact of racial microaggressions on mental health: Counseling implications for clients of color. Journal of Counseling & Development, 92(1), 57–66. https://doi.org/10.1002/j.1556-6676.2014.00130.x

National Nurses United. (2020). Sins of omission: How government failures to track COVID-19 data have led to more than 1,700 health care worker deaths and jeopardize public health. https://www.nationalnursesunited.org/sites/default/files/nnu/graphics/documents/0920_Covid19_SinsOfOmission_Data_Report.pdf

Ocampo, A. C. (2016). The Latinos of Asia: How Filipino Americans break the rules of race. Stanford University Press.

Oh, S., Litam, S. D. A., & Chang, C. (in press). COVID-19 fueled subtle and blatant racism and stress-related growth among international Asians in the United States: The roles of ethnic identity, resiliency, and coping. Asian American Journal of Psychology.

Pacquiao, D. (2004). Overcoming stigma and mental illness among Filipinos. Presentation at the National Conference of the New York Coalition for Asian Mental Health. New York Academic of Medicine, New York.

Pasco, A. C. Y., Morse, J. M., & Olson, J. K. (2004). Cross-cultural relationships between nurses and Filipino Canadian patients. Journal of Nursing Scholarship, 36(3), 239–246.
https://doi.org/10.1111/j.1547-5069.2004.04044.x

Pew Research Center. (2013). The rise of Asian Americans. https://www.pewsocialtrends.org/2012/06/19/the-rise-of-asian-americans

Poon, L. (2020, April 7). What bigotry looks like during social distancing. Citylab. https://www.citylab.com/equity/
2020/04/coronavirus-racism-hate-crimes-asian-americans-xenophobia/609517

Ratts, M. J., & Greenleaf, A. T. (2018). Counselor–advocate–scholar model: Changing the dominant discourse in counseling. Journal of Multicultural Counseling and Development, 46(2), 78–96.
https://doi.org/10.1002/jmcd.12094

Ratts, M. J., Singh, A. A., Nassar-McMillan, S., Butler, S. K., & McCullough, J. R. (2016). Multicultural and social justice counseling competencies: Guidelines for the counseling profession. Journal of Multicultural Counseling and Development, 44(1), 28–48. https://doi.org/10.1002/jmcd.12035

Ruiz, N. G., Horowitz, J. M., & Tamir, C. (2020). Many Black and Asian Americans say they have experienced discrimination amid the COVID-19 outbreak. Pew Research Center. https://www.pewsocialtrends.org/2020/07/01/many-black-and-asian-americans-say-they-have-experienced-discrimination-amid-the-covid-19-outbreak

Sanchez, F., & Gaw, A. (2007). Mental health care of Filipino Americans. Psychiatric Services, 58(6), 810–815. https://doi.org/10.1176/ps.2007.58.6.810

Seider, S., Clark, S., & Graves, D. (2020). The development of critical consciousness and its relation to academic achievement in adolescents of color. Child Development91(2), e451–e474. https://doi.org/10.1111/cdev.13262

Shea, M., & Yeh, C. (2008). Asian American students’ cultural values, stigma, and relational self-construal: Correlates of attitudes toward professional help-seeking. Journal of Mental Health Counseling, 30(2), 157–172. https://doi.org/10.17744/mehc.30.2.g662g5l2r1352198

Smith, M. J., & Weinstock, D. (2019). Reducing health inequities through intersectoral action: Balancing equity in health with equity for other social goods. International Journal of Health Policy and Management, 8(1), 1–3. https://doi.org/10.15171/IJHPM.2018.103

Sue, D. W., Sue, D., Neville, H. A., & Smith, L. (2019). Counseling the culturally diverse: Theory and practice (8th ed.). Wiley.

Taylor, S., Landry, C. A., Paluszek, M. M., Fergus, T. A., McKay, D., & Asmundson, G. J. G. (2020). Development and initial validation of the COVID Stress Scales. Journal of Anxiety Disorders, 72(2020), 1–7.
https://doi.org/10.1016/j.janxdis.2020.102232

Tuason, M. T. G., Taylor, A. R., Rollings, L., Harris, T., & Martin, C. (2007). On both sides of the hyphen: Exploring the Filipino-American identity. Journal of Counseling Psychology, 54(4), 362–372.
https://doi.org/10.1037/0022-0167.54.4.362

Tuazon, V. E., Gonzalez, E., Gutierrez, D., & Nelson, L. (2019). Colonial mentality and mental health help-seeking of Filipino Americans. Journal of Counseling & Development, 97(4), 352–363. https://doi.org/10.1002/jcad.12284

U.S. Department of Justice. (2020). Coronavirus is no excuse for hate: Remembering Vincent Chin. Department of Justice, U.S. Attorneys’ Office, District of Idaho. https://www.justice.gov/usao-id/pr/coronavirus-no-excuse-hate

Watts, R. J., & Hipolito-Delgado, C. P. (2015). Thinking ourselves to liberation? Advancing sociopolitical action in critical consciousness. The Urban Review, 47(5), 847–867. https://doi.org/10.1007/s11256-015-0341-x

Woo, B., Maglalang, D. D., Ko, S., Park, M., Choi, Y., & Takeuchi, D. T. (2020). Racial discrimination, ethnic-racial socialization, and cultural identities among Asian American youths. Cultural Diversity & Ethnic Minority Psychology, 26(4), 447–459. https://doi.org/10.1037/cdp0000327

Worldometer. (n.d.). Covid-19 coronavirus pandemic. https://www.worldometers.info/coronavirus/#countries

 

Christian D. Chan, PhD, NCC, is an assistant professor at the University of North Carolina at Greensboro. Stacey Diane Arañez Litam, PhD, NCC, CCMHC, LPCC-S, is an assistant professor at Cleveland State University. Correspondence may be addressed to Christian D. Chan, Department of Counseling and Educational Development, The University of North Carolina at Greensboro, P.O. Box 26170, Greensboro, NC 27402, cdchan@uncg.edu.