In 2022, nearly 1 million international students attended college in the United States.
Can you guess the leading countries of origin?
According to the Open Doors Data on International Educational Exchange, approximately 75% of international students came from Asia, from which the two major represented countries were China (31%) and India (21%). Of the remaining regions, 11% came from the Americas, 8% from Europe, 5% from Africa and <1% from Oceana.
These 1 million international students in 2022 represented 5.8% of the 17 million total student population. As a minority group, international students often face additional challenges including language barriers, academic pressure, homesickness, financial constraints, bicultural tension, culture shock, and discrimination. Yet, they often have fewer mechanisms to resolve these problems than domestic students.
These were some of the same obstacles that Dr. Lei Wang faced when she embarked on her academic journey. Originally born in Taipei, Taiwan, Lei moved to Texas with her mother, who was also an international student, at age 5. She attended school in Houston for two years before moving back to Taiwan. Driven by her interest in the human mind and in helping others, she decided to pursue counseling and educational psychology at National Taiwan Normal University. She continued this education by returning back to the US to the University of Missouri for her master’s in counseling psychology and Indiana University where she earned her doctorate degree.
Drawing from her own experiences as an international student, Lei decided to pursue “me-search” to see if her experiences resonated with other international students. This exploration ultimately led her to become interested in delving into racialized experiences while acculturating into new cultures. Motivated by her own journey and the challenges she encountered, she dedicates herself towards supporting students facing similar experiences.
Anise Health sat down with Lei to uncover the insights of her research and discuss how international students can be better supported by allies and mental health clinicians.
What are specific challenges that international students face when it comes to acculturation and/or seeking help for their mental health? Why do you think this is the case?
“One of the things that international students experience when they come to the states, they’re here to study. They often forget or deprioritize other aspects of their life.” – Dr. Lei Wang
Anecdotally, Dr. Wang notices in her private practice and research that international students tend to prioritize academics, which stems from cultural expectations and the desire to make the most of their education abroad. They often feel an obligation to excel in their studies, not only for themselves, but also for their family back home. This sense of duty and responsibility could lead to difficulties adjusting to the culture they have moved into. Furthermore, international students often face legal and regulatory policies that restrain them from earning supplemental income, thus compounding these inherent issues. With a combination of academic pressures, acculturative stress, and financial difficulties, this could become an overwhelming experience for international students. Many of them turn to counseling centers for support, but these programs are often not accessible due to long wait times or are limited by the short-term model. Additionally, counseling centers may not have therapists who match their client demographics or are ill-equipped to provide culturally-responsive care. Unfortunately, it is often hard for international students to find care off campus as well given the difficulty of navigating insurance, therapist-client match, etc.
How do you and other clinicians support international students through your work? What tools or techniques do you think would be helpful for students to know?
“It is important for clinicians to be the leading role and model for the clients what that might look like.” – Dr. Lei Wang
Many international students who come from Asian or African backgrounds where demonstrating respect for professionals and elders are emphasized. This is reflected in the clinical space where these students often treat counselors or therapists as medical doctors or as authority figures, expecting that their therapist will tell them what to do. To address this, psychoeducation can be helpful in informing patients how counseling works and foster a more collaborative approach.
Additionally, clinicians can incorporate cultural factors into their services to make sure they are accounting for the values and backgrounds of their patients. For example, Lei often provides Mandarin counseling services. Patients are often referred to her when looking for a clinician who speaks their native language because they understand that most painful memories are stored in those languages. Yet, it can be healing to use another language (i.e., English) for them to reframe their experiences. While research shows that the racial background of the counselor does not necessarily matter in the long run, having clinicians who are from a similar background as clients can often help break down the stigma of seeking mental health and encourage clients to make the initial appointment. During the therapy process, it is essential to keep in mind that both the therapist and client can make assumptions about each other, especially when they have a shared cultural background.
“Being able to be curious and not make those assumptions is important.” – Dr. Lei Wang
Another thing she constantly hears from clients is: “I want an Asian woman therapist because my previous therapist has told me to cut off my family.” Most often, Western psychology emphasizes setting boundaries from an individualistic perspective. While it is possible that the therapist encouraged setting healthy boundaries, the client could have perceived it as something that did not necessarily match their cultural expectations of being part of the family unit. This highlights the importance of communication and the way interventions are adapted to meet the needs of clients in a culturally sensitive manner. It is also essential to incorporate more creative approaches and to not solely rely on manualized treatments.
International students often face extra barriers (e.g., language, culture shock, social isolation) when pursuing their goals and dreams in the US. Any suggestions on ways to handle these barriers and thrive in a foreign culture?
“Research shows that if you’re working with someone with an international background, they do enjoy it when asked about their background.” – Dr. Lei Wang
Clinicians often shy away from asking international patients this question because it involves thinking about visas and whether to stay in the states, creating a complicated situation. Discussing immigration matters, in particular, can be challenging. Therefore, it is important for clinicians to educate themselves about student visas, collect resources on immigration lawyers nearby that are available, and gather support resources for their patients.
Lei authored a book, iTHRIVE: An International Student’s Guide to Thriving in the US,
that offers guidance on holistic wellness that encompasses spirituality, community, finances, legal considerations, academic, career, and social life for international students. Given that international students are viewed as a more vulnerable population, it is necessary to provide them with the support and guidance they need. This includes providing guidance on navigating various systems in place, learning how to ask relevant questions about insurance coverages, and connecting students to resources.
What steps do you plan on taking to improve your approach in working with international students?
“I am eager to build a community of colleagues who I can meet regularly with to consult on cases to continue to improve my clinical skills and my work with international students. I am excited for the possibility to also train and supervise future therapists to provide culturally sensitive care to international students. In addition, I’m interested in building a network of providers so I can refer potential clients because of my limited availability. When Anise Health reached out to me, it was such a welcoming surprise, and I’m eager to explore what greater involvement could look like.” – Dr. Lei Wang
About Dr. Lei Wang
Lei Wang, Ph.D., is a licensed psychologist, published author, assistant professor, and COO of Liberate The Block. Her research focuses on mental health among Asian American and Asian international students, bilingual counseling, and clinical training and supervision. She specializes in working with the university population (staff/faculty/students) and women and people of color in STEM and business. Learn more about her here: www.drleiwang.com
Check out her book, iTHRIVE here: https://www.amazon.com/dp/195372003X
About Anise Health
Anise Health is a culturally-responsive mental health platform for the Asian community. Learn more about Anise Health’s clinical care model and 1:1 culturally-responsive services available in California, New York, Massachusetts, Washington, and Florida on our website here. For clients in California, Anise Health now accepts Aetna and Healthnet insurance plans.
If you live elsewhere in the US, are looking for something a bit lighter touch, or run an organization that wants to partner with us – be sure to also check out our group services including psychoeducational webinars, interactive workshops, peer support circles, and more!
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