The Development and Implementation of a Psychoeducational Support Group for International Students

Pornthip Chalungsooth, Ed.D.
University of Scranton
Scranton, Pennsylvania, USA

Alexander S. Faris, Ph.D.
University of Wisconsin
Madison, Wisconsin, USA

 

Abstract   

International students frequently experience problems related to cross-cultural adjustment.  The authors describe a theoretically-based psychoeducational support group designed to address their intellectual and emotional needs.

 

International student enrollment at American universities and colleges is growing as a result of various national, state, and campus initiatives.  Indeed, many of the 600,000 international students currently studying in the United States were recruited for the cultural diversity, academic prestige, and financial resources they bring to their institutions and communities (Institute of International Education, 2007).  Given the sizeable and valued presence of international students, college personnel have a stake in helping international students succeed.  In this paper, we describe a theoretically-based psychoeducational support group designed to address some common challenges international students face, most of which relate to cross-cultural adjustment.

Cross-Cultural Adjustment Concerns of International Students
Although all students encounter some stressful circumstances during college, international students face many special challenges as they transition into new academic and social roles (Thomas & Althen, 1989; Mori, 2000).  For instance, large geographic distances typically separate them from family members and friends, thereby decreasing accessibility to familiar support networks.  Homesickness is a common experience for this population, as many international students miss loved ones, traditions, holidays, ethnic food, and other comforts of home.  Language difficulties are another source of stress for international students, and individuals with underdeveloped language skills report lower levels of academic success and social functioning (Mori, 2000; Pedersen, 1991).  Academic distress is particularly problematic for international students because they often arrive to the United States with expectations of maintaining or advancing their status as talented students (Arthur, 2004).  International students must also adjust to an American education system that is defined by very different values, beliefs, customs, and traditions.  Students who are familiar with different teaching methods and examination schedules are forced to develop new learning strategies and learning patterns.  The nature of interpersonal relationships in America may confuse international students, as well (Pedersen, 1991).  Even if international students become acculturated to America, they will ultimately face the daunting task of reentering their home countries with altered self-concepts and worldviews (Arthur, 2004). 

Although international students experience more stressors than their American peers, studies indicate that they are less likely to seek assistance from mental health clinicians (e.g., Yahushko, Davidson, & Sanford-Martens, 2008).  Several factors may relate to the underutilization of services: cultural differences between counselors’ and clients’ values, language barriers, student help-seeking attitudes, and difficulty with diagnosis.  Fortunately, there is a growing literature devoted to improving the breadth and quality of services available to international students (e.g., Sue & Sue, 2008).

Support groups provide international students with an important forum for addressing adjustment-related concerns and having their concerns validated (e.g., Carr, Koyama, and Thiagarajan, 2003).  They facilitate acculturative processes by promoting social interaction, enhancing English-speaking ability, teaching coping skills, fostering hope, and normalizing members’ experiences in a safe environment.  As members see their peers challenging themselves and making desired changes in their lives, it gives them hope that change is possible for themselves (Corey & Corey, 2010).  Furthermore, social theorists believe that social support is essential because it contributes directly to the satisfaction of multiple personal needs, including affiliation, belonging, respect, social recognition, affection and nurturance (Lazarus & Folkman, 1984; Vaux, 1988).  Satisfying these needs appears to lower stress as well as the prevalence of psychopathological symptoms (Ramsay et al., 2006).  In sum, support groups are a cost-effective means to assist international students who face significant adjustment-related challenges at American collegiate institutions (Dipeolu, Kang, & Cooper, 2007).

Overview of Support Group
Members of two university offices, Counseling and Psychological Services (CAPS) and International Students and Scholars (ISS), collaborated to form a support group for international students.  The collaboration was a programmatic response aimed at facilitating international students’ adjustment to a mid-sized, southern state university and surrounding community.  Existence of the support group was publicized via electronic mail to all international students who subscribed to the ISS list-serve.  The group was described as a safe place to maximize one’s educational experience by discussing issues that commonly affect international students.  Friends and spouses were also encouraged to attend the meetings, which were held for 90 minutes during the first eight Monday evenings of each semester.  The group convened at the university’s coffee house, a location that was easily accessible and familiar to most students.  Students who wanted to receive confidential services could become clients at CAPS.

The size and make-up of the support group varied from week to week.  On average, 5 to 8 students attended each meeting and most of them were new arrival students with few “established” international undergraduate students, including spouses (typically 0-2 individuals) and friends (typically 0-2 individuals).  The home countries of the group members spanned from Asia (India, Indonesia, Japan, Malaysia, Sri Lanka, Thailand, and Vietnam) to the Middle East (Lebanon and Serbia) to Latin America (Argentina, Brazil, and Ecuador).  The group was co-ed and ages ranged from 18 to 25 years old.

At the beginning of each session, the facilitators reviewed confidentiality standards as part of the informed consent process.  The facilitators then offered didactic information on a particular topic that had been identified in the research literature as relevant to the mental health needs of international students.  A strong effort was made to provide a safe, non-judgmental milieu in which all students could explore their difficulties, express their reactions, and formulate new ideas.  The facilitators modeled attentive listening, empathic communication, openness to different viewpoints, and acceptance of emotional expression.  After each session, the facilitators solicited verbal feedback from the members.

Below is an outline of the specific objectives and procedures for the 8-week-long support group.  Although a specific topic was designated for each meeting, the content of the meetings overlapped at times.  Notably, “Homesickness and Loneliness” (Week 3) were persistent concerns for most group members, and they were frequently discussed in the context of “Friendship” (Week 1), “American Culture” (Week 2), “Holiday Isolation” (Week 7), and “Cross-Cultural Dating” (Week 8).  Other group topics included “America’s Educational System,” “Money Management,” and “Stress and Time Management.”

Objectives and Procedures
Week One – “Friendship”
“Friendship” was the first topic because newly-arrived international students were often most concerned with establishing social connections.  A central objective of this session was to promote socialization within the group by encouraging self-disclosure and establishing a group norm for peer participation.  Some students felt apprehensive about introducing themselves to other group members.  However, the discomfort usually dissipated as group members realized that they could simply listen during the didactic portion of the meeting.  During the didactic presentation, a facilitator helped students understand how definitions of friendship vary across cultures (e.g., how Americans may use the term “friend” loosely; Althen, 2002).  Asian students in attendance shared their opinions that more stringent criteria were applied to friendship in their home countries, elaborating with comments such as, “When one is someone’s friend, she or he will be a friend for life.”

Week Two – “American Culture”
The second topic, “American Culture”, involved a didactic presentation and discussion about core American values, including self-reliance, time management, privacy, egalitarianism, change/mobility, independence, free-enterprise, future orientation/optimism, active engagement, directness, honesty, practicality/efficiency, and materialism/acquisitiveness (Althen, 2002).  Group members then conversed about how these values related to core values in their home countries.  Group facilitators encouraged students to consider how living in America might influence their own personality development and belief systems.  During the discussion, students began to anticipate potential problems associated with re-entry or “reverse culture shock” (Arthur, 2004).  Lebanese students raised concerns over being perceived as “too Americanized” upon returning home.  The facilitators listened attentively, provided empathic feedback, and encouraged group members to further explore their thoughts on the matter.

Week Three – “Homesickness and Loneliness”
The co-leaders helped students discover how best to cope with homesickness and loneliness (Oguri & Gudykunst, 2002).  While discussing an array of coping methods (e.g., reading foreign newspapers on-line), the facilitators provided students with information about activities and resources at the university (e.g., a list of registered student organizations—some of which were international student groups).  They also dissuaded students from over-relying on loved ones in their native countries for social support.  They stressed the potential value of establishing new relationships at the university and within the community, adding that many international students limit their social opportunities by associating only with fellow nationals (Wright, 1987).  Most students agreed with the recommendations made by the group facilitators; however, they frequently remarked that their time was too limited to participate in extracurricular activities.  Students from Malaysia and Serbia cited their lack of transportation as a barrier to becoming more involved in the greater community.  Informing them about the public transportation system offset some of their concerns about mobility.

Week Four – “America’s Educational System”
The leaders presented an overview of America’s educational system, paying particular attention to the professor-student relationship (e.g., how to approach a professor with a question), instructional format (e.g., adjusting from discussion-style to lecture-style classes), assignment completion (e.g., working in groups as opposed to individually), and exams (e.g., adapting to a higher frequency of quizzes and tests).  Additionally, the facilitators recognized that many international students felt intense pressures to excel in their studies (Pedersen, 1991).  Nearly all members of the group, including the Japanese, Thai, and Vietnamese students, talked about how studying and communicating in English inhibited their ability to demonstrate their knowledge, skills, and abilities to professors.

Week Five – “Money Management”
Due to governmental policies regarding employment eligibility, many international students face budget shortfalls (Thomas & Althen, 1989; Arthur, 2004).  A local bank representative attended the fifth meeting to share information about effective money management practices.  Students typically asked questions about checking accounts, credit card restrictions, loan options, and interest rates.  Additionally, the co-leaders addressed students’ inquiries about how to maximize their income while operating within legal parameters (e.g., working on campus for 20 hours under the United States Citizenship and Immigration Services regulations).

Week Six – “Time and Stress Management”
The leaders taught students about the positive and negative functions of stress.  Group members assessed their own stress levels with checklists and psychological measures, an activity that fostered discussion and informed participants about the risk factors and warning signs of excessive stress.  The facilitators emphasized the connection between mind and body, because most international students exhibited physical problems as a consequence of their anxiety (e.g., headaches, gastrointestinal disturbance, and poor sleep quality).  A discussion about stress management strategies typically ensued, and group members received information about breathing and relaxation techniques.  Students also shared their own suggestions for stress management (e.g., cooking an ethnic meal).  The session concluded with progressive muscle relaxation or a deep breathing exercise.

Week Seven – “Holiday Isolation”
Holiday periods are especially lonely times for many international students, because traveling home is not a viable option.  During this meeting, the group leaders encouraged students to consider the possibility of spending holidays with a host family or American friends when the opportunity existed.  The facilitators framed American holidays such as Thanksgiving as opportunities for cultural learning.  Group facilitators also reminded students about which government documents to carry when leaving campus.

Week Eight – “Cross-Cultural Dating”
Co-leaders presented concepts and terminology associated with dating in the United States.  Group members, particularly those from Asia and Middle Eastern countries, described how romantic relationships in America compared and contrasted with romantic relationships in their home countries.  Occasionally, a student inquired about how inter-racial or cross-cultural dating was perceived by the general American public.  The topic of dating almost always generated lively and animated interactions among the international students.  The final portion of the session was devoted to summarizing the support group experience and sharing the overall verbal feedback which members gave.  Eighty percent of the students reported that group support helped them cope with adjustment issues.  The remaining twenty percent of the students did not express opinions about whether they benefited from the support group.

Discussion
Developing and implementing a successful psychoeducational support group for international students often necessitates collaboration among university agencies.  For example, college mental health staff might market the support group through the international programs office, admissions office, English as a Second Language (ESL) program, multicultural center, and study abroad programs.  Staff members in such offices usually stay in close contact with international students from the time they arrive for orientation until graduation, and they are in excellent position to identify students who are struggling with adjustment.  Moreover, international students may feel more comfortable with attending a support group if the idea is proposed by someone who is familiar to them.

As noted earlier, international students may view any form of counseling as stigmatizing (Aubrey, 1991).  Because the term “support group” may deter some individuals from attending meetings, referring to the group by a more inviting name may assuage international students’ concerns.  We noticed a dramatic increase in attendance after changing the group name from “International Students Support Group” to “Monday Night Chat.”  For similar reasons, it may be beneficial to hold group meetings in a location other than the counseling agency.  Hosting meetings in easily accessible and somewhat casual places (e.g., the student union, study abroad program office) may have unique advantages.  For instance, American students with study abroad experience who happen to be present may mix into the group, thereby adding a dynamic that enhances discussions and fosters a sense of belongingness (Jacob & Greggo, 2001).

Although we believe support groups can be helpful for many international students, there are some possible limitations.  If some international students feel disgraced, immature, and weak when sharing problems with professionally trained counselors (Uba, 1994), then they are probably less likely to share sensitive information with counselors and fellow students present.  Some students may avoid the support group entirely, and those who attend may refrain from expressing thoughts and emotions that others could construe as pathological.  Another potential drawback of the group model concerns variability in English competency (Dipeolu, Kang, & Cooper, 2007).  International students who lack confidence in their English speaking ability might eschew situations wherein they must communicate before an audience of peers.  Interventions involving drawing, painting, and other artful activities may be useful as means to help students who lack confidence in their verbal communication skills.  Research indicates that play therapy techniques are effective for use with cultural groups that are highly accustomed to non-verbal communication patterns (Gil & Drewes, 2005).

In conclusion, this article presents practical suggestions to consider when addressing the many needs of international students, a traditionally underserved population.  Mental health professionals and counselor educators may team together to facilitate international students’ adjustment by creating a comfortable atmosphere, validating struggles, promoting knowledge of critical topics, and offering coping strategies.  Support groups provide potentially valuable opportunities to learn, discuss, and explore sojourn experiences as they pertain to both intellectual and emotional development.

 

References
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Aubrey, R. (1991). International students on campus: A challenge for counselors, medical providers, and clinicians. Smith College Studies in Social Work, 62, 20-33.

Carr, J. L., Koyama, M., & Thiagarajan, M. (2003). A women’s support group for Asian international students. Journal of American College Health, 52, 131-134.

Corey, M. S., & Corey, G. (2010). Groups: Process and practice (8th ed.). Pacific Grove, CA:  Brooks/Code.

Dipeolu, A., Kang, J., & Cooper, C. (2007). Support group for international students: A counseling center’s experience. Journal of College Student Psychotherapy, 22, 63-74.

Gil, E., & Drewes, A. A. (2005). Cultural issues in play therapy. New York: Guilford.

Institute of International Education, Open Doors (2007). International student enrollment in the U.S. Retrieved August 23, 2008, from http://www.iie.org.

Jacob, E. J., & Greggo, J. W. (2001).  Using counselor training and collaborative programming strategies in working with international students.  Journal of Multicultural Counseling and Development, 29, 73-88.

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Pedersen, P. B. (1991). Counseling international students. Counseling Psychologist, 19, 10-58.

Ramsay, S., Jones, E., & Barker, M. (2006). Relationship between adjustment and supportive types: Young and mature-aged local and international first year university students. Higher Education, 45, 247-265.

Sue, D. W., & Sue, D. (2008). Counseling the culturally different: Theory and practice (5th ed.). New York: Wiley.

Thomas, K., & Althen, G. (1989). Counseling foreign students. In P. B. Pedersen, J. G. Draguns, W. J. Lonner, & J. E. Trimble (Eds.), Counseling across cultures (3rd ed., pp. 205-241). Honolulu, HI: University of Hawaii.

Uba, L. (1994).  Asian Americans: Personality patterns, identity, and mental health. New York: Guilford.

Vaux, A. (1988). Social support: Theory, research, and intervention. New York: Praeger.

Wright, D. J. (1987). Minority students: Developmental beginnings. New Directions for Student Services, 38, 5-21.

Yakushko, O., Davdison, M. M., & Sanford-Martens, T. C. (2008). Seeking help in a foreign land: International students’ use patterns for a U.S. university counseling center. Journal of College Counseling, 11, 6-18.


Author Note
Pornthip Chalungsooth, Ed.D., Department of Counseling and Human Services, University of Scranton.

Alexander S. Faris, Ph.D., Counseling and Consultation Services, University of Wisconsin-Madison.

We thank J. Judd Harbin, Greg Schneller, and Elizabeth Jacob for reviewing the manuscript prior to its submission.  We also acknowledge Audra Johnston and Cornell McClellan for their contributions to the international students support group.

Corrrespondence concerning this article should be addressed to Pornthip Chalungsooth, Ed.D., University of Scranton, Department of Counseling and Human Services, 437 McGurrin Hall, Scranton, PA 18150-4523. Phone: 570-941-4163; Fax: 470-941-5882; E-mail: chalungsoop2@scranton.edu.

 

 


This article was published in Human Services Today, Fall 2009 , Volume 6, Issue 1 .
http://hst.coehs.uwosh.edu This article may be freely distributed for educational purposes provided above copyright information is included.


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