BRYCS Featured Program

FEATURED PROGRAM FOR JULY 2005:

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The Social Adjustment Program for Southeast Asians (SEA)

Administering Organization
Amherst H. Wilder Foundation

Program Objectives and Unique Needs Addressed
The goal of the SEA Program is to address mental health and social adjustment issues of Cambodian, Hmong, Vietnamese and Lao immigrants and refugees of the greater St. Paul metropolitan area in a culturally and linguistically appropriate manner, thereby improving the mental health of the target populations.

Strategies used to achieve the above goal:

Employ staff that share a common culture and language with the clients we serve;
Provide culturally competent mental health services that integrate western mental health with traditional healing practices of Southeast Asian culture;
Provide both community-based and office-based services.

Program Description
We provide a variety of services to Southeast Asian youth and adults by bilingual and bicultural counselors trained in Western mental health practices. These services focus on families, youth and children, adult and groups with special needs or considerations

Family Services include: SEA Hmoob Koom Siab (Hmong Working Together/Families and Schools Working Together); Family Connect - a parent education program for Cambodian & Vietnamese parents using the promising practice "Parenting Across Cultures" model to help participants integrate traditional and Western parenting styles; and Functional Family Therapy, an in-home family therapy that uses the Functional Family Therapy best practice model, with referrals from Ramsey County Juvenile Corrections.

The SEA Hmoob Koom Siab (Hmong Working Together/Families and Schools Working Together) is based on the national best practice Families and Schools Together (FAST) Program. The main objectives of FAST are: 1) Strengthen family ties and improve communication; 2) Enhance child’s success in school and at home; 3) Reduce child and family substance abuse involvement; and 4) Increase social support networks, and reduce daily stresses, and 5) Enhance parents’ connection with their children’s schools. We have adapted the FAST program to specifically address the challenges Hmong youth face in straddling two cultures and the need in the Hmong community to have a better understanding of the American educational system.

The SEA Hmoob Koom Siab/Hmong Working Together program has been culturally adapted to serve the Hmong community in the greater St. Paul area. One evening a week, for 10 weeks, Hmong families gather for “family night.” At the events, the families share a meal, sing traditional Hmong songs, and break out into parent and youth discussion groups to discuss issues related to their families or school, have a one to one discussion between parent and middle school youth and, finally, a family connection game is played. A variety of mental health counselors, chemical abuse specialists and youth leaders are on hand to assist the discussion groups. Specific adaptations made for the SEA Hmoob Koom Siab/Hmong Working Together program were: all of the program team members are Hmong, to sing Hmong songs and tell Hmong stories to the children, and make sure instruction given to the parents is done in a culturally appropriate manner (e.g. male team members provide coaching and support to fathers and female team members do the same for mothers). The program also provides after school youth groups, school and home visits, field trips and youth leadership retreats.

Youth and Children services include: Youth Mental Health, which provides mental health screening, individual and group counseling at schools and in-home visits for family counseling; and Children's Mental Health Case Management, which assists youth under 18 with a diagnosis of severe emotional disturbance achieve stability in their families, communities and schools.

Adult services include: Adult Mental Health and Social Services, which helps adults with mental health and acculturation difficulties to reduce stress and mental health symptoms; Adult Mental Health Case Management, which helps county-referred seriously and persistently mentally ill (SPMI) clients reduce their symptoms and maintain stability in their communities; Assertive Community Treatment framework - a nationally recognized "evidence-based practice" which uses a multidisciplinary team and reduced case load size to work with the seriously and persistently mentally ill (SPMI) client who is most at risk.

Services for groups with special needs or considerations include: support and psycho-educational groups for Hmong, Cambodian, and Vietnamese adults; and Hmong Odyssey, which enhances the adjustment process of Hmong families arriving from Wat Tham Krabok through a range of education, early identification and treatment services.

Resource Materials Used in Program
The SEA program provides training & consultation services regarding Southeast Asian cultural and mental health issues to public and private organizations within the community. We have also developed children's mental health audiotapes for parents who could not read or write in their own language. Fact sheets have also been developed and printed in the languages of the populations served by the Program.

Groups Served by Program
The SEA program serves children, youth, adults and families in the Hmong, Cambodian and Vietnamese communities of Saint Paul, MN.

Program Funding
The SEA program receives federal funding from the Office of Refugee Resettlement (ORR). We also receive funding from a variety of other sources at various levels, including: state funding from MN Department of Human Services, Title II, Ramsey County, private foundations, and 3rd party payers including medical assistance, HMO's and the Wilder Foundation endowment.

Program Staffing and Required Staff Training
The SEA program consists of 32 Mental Health Staff (including 2 Vietnamese-speaking, 6 Cambodian-speaking, 15 Hmong-speaking, 4 LICSWs, 2 LGSWs and 3 staff with other Master’s degrees); 11 Program Service Aids (3 Cambodian-speaking, 8 Hmong-speaking) and 4 Administrative Services staff, two of which are Hmong-speaking. In 2004-2005, more than 50 volunteers worked with the SEA program.

All of our staff are trained in Western mental health practices and supervised by licensed mental health staff. All of our counselors are familiar with traditional healing methods as well as the use of cultural resources to resolve family issues.

Depending on credentialing and program, staff are required to have continuing education credits. Opportunities for training and in-services are provided both internally and externally.

Defining Program Success
Programs are evaluated by the Wilder Research Center for program effectiveness and participant satisfaction. Demographic and service data are gathered on all clients. The Mental Health Statistics Improvement Program (MHSIP) Consumer Survey is completed for all clients six months after intake.

Program Additional Comments
Lessons Learned:

Evidence based best practice models can be effectively provided if there is considerable room for cultural adaptation of the model.

Mental health services must be culturally and linguistically appropriate if they are to effectively serve Southeast Asians.

Services must be accessible to clients, and thus home- and community-based services, or transportation must be provided to the program.

The lack of licensed mental health professionals restricts access to mainstream mental health funding. To help culturally skilled staff increase their qualifications, the program subsidizes undergraduate and graduate level education.

Non-categorical funding is needed to help facilitate the integration of services.

Increasing levels of alcohol abuse signal a need for culturally contexted education and prevention in this area as well as for training of SEA staff.

To help the community and participants overcome the stigma of mental health, staff need to be creative and innovative. A women's depression group used traditional Hmong quilting as a way to begin developing trust with one another and to share their stories. Gardening groups for SEA elders has been found to be very therapeutic as opposed to "talking" therapy groups.

In addition to providing services for their clients, staff must consistently advocate for the needs of their clients, including increasing the capacity of mainstream agencies to integrate with SEA's services.

Through implementation of two best practice models, the SEA program is moving toward greater inclusion of parent and youth in leadership roles and in ongoing support such as parent support groups and parent mentoring.

Program Outcomes
According to participant satisfaction data for 2000-2001 the SEA program is very successful. 85% of adult participants and 53% of youth participants said they would recommend the program. 90% of adult participants and 100% of the youth participants said they were "satisfied" or "very satisfied" overall with the benefits they received from the program.

Evaluation data from 2000-2001 on Program Effectiveness indicate that 50% of the clients improved in withdrawal, depression and anxiety; 90% improved in family functioning; 56-63% improved in other common problems. On the GAF, 64% of adults improved by at least 10 points from intake to 6 months later. In the youth program, 80% of the participants improved by at least 10 points on the GAF.

Specific outcomes from the 2000-2001 Program Summary indicate that 520 youth and adults were served, with an average of 30.8 hours per client.

Other Key Elements
Collaborations within the community are key to SEA's provision of services, the collaborations include: adult case management program for SEA adults with Ramsey County Mental Health for SEA adults with a diagnosis of serious and persistent mental illness (SPMI). Prior to the collaboration with Ramsey County Mental Health, SEA adults with SPMI worked with mainstream providers with little or no knowledge of the client's culture or language.

We have also developed partnerships with several EBCOs (ethnic-based community organizations) in the greater St. Paul area: the Hmong Cultural Center, the Hmong American Partnership, Lao Family Community; The Hmong 18 Clan Council and United Cambodian Association.

Program Contact
Linda Gensheimer, PhD, LICSW, Director; lcg@wilder.org; 651-647-9676

Program Dates
This program began in 1983; it is still operating.

You can find more programs and information about this and other organizations by searching the BRYCS Clearinghouse.