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Skip Navigation LinksNASP Home Publications Communiqué Volume 40, Issue 4 Mental Health Professionals Unite

Mental Health Professionals Unite to Support Japanese and Japanese Americans

By Maiko Ikeda, Jennifer Saeko Inaba, Ayako Christina Ikeda, & Miki Kihara

Miki Kihara, Maiko Ikeda, Ayako Ikeda, and Jennifer Inaba

Miki Kihara, Maiko Ikeda, Ayako Ikeda, and Jennifer Inaba, San Diego State University

On Friday, March 11, 2011, one of the worst disasters in the world hit the country of Japan. A magnitude 9.0 earthquake struck off the coast of Japan, forever changing the lives of the people and the state of the country. Not only were lives lost and homes destroyed, the tsunami that followed caused numerous nuclear accidents around the Fukushima nuclear power plant, forcing many to leave their homes and live in evacuation centers miles away. According to the National Police Agency of Japan, this disaster caused close to 16,000 deaths and more than 5,000 injuries. More than 8,000 people are still missing (“Damage Situation,” 2011).

While miles away from the epicenter of this natural disaster, we as mental health professionals may have encountered or may encounter Japanese and Japanese American individuals in the United States who were affected by this event. The authors of this article are Japanese and Japanese American school counselor and school psychology graduates and students residing in San Diego, CA, who came together to bring about awareness regarding this situation. Three of the authors are graduates or current students of San Diego State University's school psychology program, which places a strong emphasis on supporting culturally and linguistically diverse students and their families and urges professionals to bring culture to the forefront.

This article will address various perspectives of those affected by the earthquake,

an overview of the efforts of the mental health professionals in Japan and abroad, and cultural considerations when working with Japanese students in the school system.

The Earth quake Through the Eyes of Japanese and Japanese Americans in the United States

Below we share perspectives on the earthquake as viewed through the eyes of individuals of varying ages, levels of acculturation, and vantage points who are of Japanese origin and are living in the United States.

Japanese girl (in the United States since 2008; 10 years old). On the morning of March 11, 2011, it appeared to be a regular day at school. However, when she arrived at school, she realized something had happened in Japan. Most of her friends and teachers kept asking if her family was all right. She became increasingly anxious. When she arrived home, her parents also communicated their concerns to her, further increasing her anxiety. Several days later, her parents noticed that their daughter had been suffering from what appeared to be fatigue.

Japanese woman (in the United States since 2010). About 5 minutes after the earthquake and tsunami happened, I happened to be checking the Japanese news on the Internet. I immediately called my parents and grandmother in Tokyo. Fortunately, I was able to get through and confirm their safety. However, their voices told me they were panicking. I felt sad for not being able to be with my family. The news reported that people had no choice but to go home on foot, due to problems with transportation. I heard that my cousin walked for 8 hours from her office to her home. I tried every possible means to obtain information about the extent of damage and hardship that survivors were facing, including Twitter, Facebook, and Ustream. It took several days to confirm that my relatives and friends were safe. Although I was relieved, I couldn't help but constantly access the Internet so I would not miss out on any breaking news since some of my friends and relatives were still in the disaster area. Some friends from Japan started asking me how the U.S. media reported on the situation of the exploded nuclear power plant. I was eager to collect information, because I wanted to make myself useful to others in some way. After a couple of weeks, I felt exhausted, so I tried to limit viewing the news and footage of the disaster. Translating the materials regarding crisis support for survivors, making paper cranes with children for donation, helping scientists who have created children's books, and sharing my feelings with my husband have helped me regain some equanimity.

Japanese woman (in the United States since 2004). It was the most dreadful 48 hours that I have ever experienced since I could not contact my family due to the shutdown of lifelines in Japan (e-mails and phone lines). I did not have any other means to get in touch with my family, such as Facebook, Twitter, and other social media that were the only means of communication during this emergency. The fear of losing my family hit me hard the moment I received news that the massive earthquake and tsunami had struck Japan. The more I collected information from the media and the more I received e-mails and phone calls from friends asking about my family's safety, the more the fear built up inside me. I purposefully limited my sources of information due to the fact that I felt myself becoming extremely anxious. Therefore, I focused at first on confirming my family and friends' safety. After a few weeks passed, I started to gather ways of supporting Japan remotely, to make myself feel better. Not only donating cash and materials, but also participating in charity events has helped me feel like I am contributing support to Japan.

Japanese American woman (born in the United States; “Nisei,” second generation). I turned on the TV while getting ready for work on the morning of March 11, 2011, and saw the devastating effects of an earthquake vividly replaying on the screen. When I realized that it had happened in Japan, a panic rushed over me and I immediately texted my cousin, without even checking exactly where the earthquake had happened. She responded within seconds; I found out that my family was safe in southern Japan and had not even felt the earthquake. I was so grateful for technology. The rest of the day when my coworkers and friends asked about my family in Japan, I thanked them for their thoughts and shared the positive news. A couple of days later, after the initial wave of relief of my family's safety had passed, I felt ashamed that I had only been thinking about my family. Since then, I became invested in supporting the Japanese people by connecting with Japanese support groups in California and joining efforts with my mother and the Japanese business community to raise funds and pray for the safety of my people.

Japanese woman (in the United States since 1989). On the morning of March 11, 2011, something told me to wake up to check my cell phone. When I checked it, my friends had left text messages and voicemails asking if my family in Japan was OK. Panicking, I rushed downstairs to find my mom watching the news about the disaster. I watched the replay of the tsunami washing away the whole town and couldn't believe my eyes. Luckily, my family lives in the southern most island of Japan and were unaffected by the disaster. In the coming days, many people expressed their concern to me and I was glad to report that my family was safe. Although I was relieved that my relatives were safe, seeing the footage of the disaster unfolding on my TV screen was shocking to me. It was hard for me to believe that the images I was seeing were from my home country. The horrible scenes made me wonder what I could do to be of some assistance to the victims of the disaster, so my brother and I decided to collect funds to donate to the victims of Japan. Being so far away from the reality of the disaster was difficult, but the support from those around us made me feel like I was at least making a tiny bit of difference for the affected people's lives.

Organizing Translation Teams to Provide Handouts for Japan

Everything started from one e-mail. On March 13, 2011, in the immediate aftermath of the devastating disaster, Dr. Toshinori Ishikuma, president of Japanese School Psychology Association (JSPA) and the Japanese Association of School Psychologists (JASP), and professor at the University of Tsukuba, called for worldwide cooperation to deal with the crisis. He first contacted his former colleagues at San Diego State University (SDSU) to request information that would help school psychologists, teachers, and parents in Japan to support children who were affected by the disaster. SDSU responded immediately. Dr. Colette Ingraham, NCSP, Director of the SDSU school psychology program, selected and e-mailed key NASP resources from the NASP website. Dr. Carol Robinson-Zañartu, former chair, and Dr. Valerie Cook- Morales, chair of the Department of Counseling and School Psychology at SDSU, contacted the National Association of School Psychologists (NASP) and communicated the need for mental health support. Katherine C. Cowan, Director of Communications at NASP, volunteered as the coordinator of these efforts and began recommending additional handouts that could be of use in Japan. Dr. Ishikuma expressed his confidence that the handouts would be a helpful aid for crisis support in Japan and urgently requested that his former students, Maiko Ikeda, NCSP, and Miki Kihara, translate the materials. Recognizing the importance of NASP's wealth of resources, Dr. Shane R. Jimerson, NCSP, professor of the Counseling, Clinical & School Psychology Program at University of California, Santa Barbara (UCSB) and PREPaRE trainer, formed another translation team to speed up the process. The latter team consisted of Dr. Yayoi Watanabe, Housei University, and Elina Saeki, PhD candidate at UCSB. These two translation teams, the SDSU team and the UCSB team, worked on translating various materials.

While the SDSU and UCSB teams began their translations, Katherine Cowan also reached out to a group of specially trained school psychologists who provide crisis response support. She contacted the NASP PREPaRE trainers, Dr. Melissa Reeves, NCSP, and Dr. Stephen Brock, NCSP, as well as the chair of NASP's National Emergency Assistance Team (NEAT) and president of International School Psychologists Association (ISPA), Dr. Bill Pfohl. Each member participated in online communication regarding support to be provided immediately and in the months to follow. Due to this collaboration, additional handouts were collected and sent as resources to Dr. Ishikuma, who led and continues to lead the government-assigned crisis response team in Japan. Some of these handouts had been created after Hurricane Katrina in 2005 and the earthquake in Haiti in 2010. With permission from NASP, the documents were translated verbatim. They were then edited to accommodate the cultural differences and special circumstances that the Japanese educational system faces.

The translated materials have been uploaded onto NASP, JSPA, and JASP websites. Furthermore, the information was provided to the Japanese Ministry of Education, Culture, Sports, Science, and Technology, as well as to the prefectural boards of education in the affected areas such as Iwate, Miyagi, Fukushima, and Ibaraki. Based on the suggestions and information exchanged, Dr. Ishikuma and his colleagues organized monthly meetings for the purpose of providing teachers and local educational boards with opportunities for consultation. They created a booklet listing these resources to distribute to schools. Furthermore, they planned to hold workshops and organize symposia at professional conferences (e.g., the Japanese Association of Educational Psychology in July and JASP in August 2011) to discuss effective mental health support for children, teachers, and parents in schools.

The Use of WorldWide Networking to Support Japan

Various individuals around the world have united in their efforts and collaborated to show their support for Japan. Scientists have created children's books to help parents inform their children of the current crisis and nuclear dangers. Different organizations, such as the Red Cross, have collected millions of dollars to provide food, clothing, and shelter to those most affected. Mental health professionals have joined international efforts to provide psychological first-aid to children and families affected by the disaster.

In our NASP group, Dr. Pfohl contacted Dr. Nishiyama, a psychology professor at Fukuoka University of Education, and had several discussions via Skype regarding the educational challenges and supports in Japan. They disseminated ideas, focusing especially on the role of school psychologists and their fatigue in this time of crisis. Dr. Pfohl suggested using Skype or Facebook as a social networking support system for professionals. Katherine Cowan contacted ISPA (International School Psychology Association) and exchanged information regarding crisis interventions with a representative in Germany. This disaster comes as a crucial reminder to the importance of establishing a strong global support network.

Cultural Considerations

“If there is not enough for everyone, I don't want to take any [food].”
“I feel like I can't cry. There are people who have experienced worse than I.”

NASP compiled questions posed by mental health professionals about how best to work with Japanese and Japanese Americans in the schools and in the community. The following are the authors' collective responses, but may not be representative of all Japanese individuals. It is also important to note that we refer to Japanese and Japanese Americans as “Japanese” due to their cultural similarities; however, their world views will differ based on individual upbringing, acculturation, and ties to Japan.

What are attitudes toward mental health and help-seeking in general? Historically, there has been a stigma associated with mental health issues among the Japanese, which has led many to believe that expressing their problems may be seen as a sign of weakness. With the introduction of school counselors into Japanese schools in 1995, Japanese students' help-seeking attitudes have changed to some degree. Some students may seek help from school counselors or mental health professionals if they have had positive experiences with school counselors in the past. Additionally, Japanese students tend to seek help from friends and family more than teachers and counselors (Mizuno, Ishikuma, & Tamura, 2006; Yeh, Arora, Inose, Okubo, Li, & Greene, 2003). Therefore, when helping Japanese students, it may be effective to facilitate peer and parent support. Furthermore, students who are more acculturated are likely to have favorable attitudes toward receiving counseling services (Atkinson & Matsushita, 1991).

What cultural concepts would be helpful for people to understand? Japanese people tend not to feel comfortable accepting great acts of help because they do not want to burden others with their problems (Lebra & Lebra, 1986). Upon acceptance of help, many Japanese people may feel the need to give back to those who helped them during a rough period of their lives. However, that should not stop others from offering help; the Japanese have been very grateful for the support they have been receiving in this crisis situation. Some Japanese people have expressed feelings of guilt for not having helped others in the past, and they will likely try to do their part to give back in the future.

Are there cultural issues in terms of communication? It is challenging to discuss cultural considerations for Japanese people, as Japanese communities seem to be in the process of changes between mura (agricultural villages) and toshi (urban communities; Hiroi, 2009). However, it is reasonable to introduce Japanese cultures based on traditional mura communities because traditional thoughts, emotions, and behavior still strongly influence Japanese people.

Japanese people are often not direct in their forms of communication (Takanashi, 2004). Therefore, if you ask about a problem, they may tell you that everything is all right even when it really is not. When Japanese are dealt with a tough situation, they are taught to gaman or hold things in without complaining, so as not to burden others (Noguchi, 2007). An exact translation does not exist in English, but this perseverance to take on what is dealt to them is strong. Therefore, Japanese students and families may have difficulty opening up to a stranger who probes for their feelings because they believe it is their responsibility to handle this situation on their own.

What are religious beliefs related to crisis, death, and grief? There are numerous religions practiced in Japan (e.g., Shinto, Buddhism, etc.). Many Japanese people believe that gods exist in nature (e.g., rivers, mountains; Kumagai, 1995). Japanese people may accept crises because of the belief that they happened for a reason. In particular, natural disasters are considered by some to be beyond human control and/or a punishment for a wrongdoing in a previous or current life (Londo, 2007). For example, some people have expressed that this recent crisis (i.e., earthquake and tsunami) happened as a punishment from Gods in nature. However, their religious beliefs also emphasize the importance of reacting in a positive manner, persevering, and overcoming the challenges that arise during crises.

Do most immigrant Japanese families live in close-knit communities here or are they more dispersed? The living situation for Japanese immigrants varies greatly. Some families may move here to work for branches of Japanese companies (e.g., Sony, Hitachi, etc.), continue medical research projects that they started in Japan, or pursue their education. Based on the reason for immigrating to the United States, some Japanese families may live in close proximity to one another and others may choose to live in more dispersed areas. If the families have personally decided to immigrate here (not due to a company assignment), they may choose to live in close proximity to other Japanese families to connect and create close-knit relationships. If the reason for immigration is due to a company assignment, some companies may not want their employees to live in close proximity to one another, while other companies encourage employees to live closer to one another. It is also important to note that starting approximately 20 years ago when the Japanese economic bubble burst, the Japanese community and support network diminished as expatriates returned to Japan as a result of companies closing their U.S. branches. Many of the Japanese who are here now are committed to remaining and acculturating to American culture.

Is there likely to be a generational difference in how people within a family may be reacting to the crisis? There is likely to be a generational difference, especially for those who have survived World War II and the atomic bombings of Nagasaki and Hiroshima. The memories of these disastrous events may affect those who experienced complete devastation, radiation threats, and loss during those times, as well as their family members. Furthermore, depending on how long the families have lived in the United States and their level of acculturation, younger children may not relate to the crisis as closely as their parents who may have lived in Japan until their adult years prior to emigrating to the United States. While reactions may vary based on the generational difference, individuals with family members residing in Japan will likely be more affected.

What are ways for professionals to be persistent with their support that won't be offensive or intrusive? If your professional instinct tells you that the student is emotionally affected, then trust your instinct and be persistent in offering your support. Provide enough time and space for responses, but continue to let the student know that you are available to him or her. You could also approach it indirectly by talking with parents and/or friends to determine how best to support the student. If students and their families still seem reluctant to share their feelings with you, it would be important to refer them to other resources in the community. They may feel more comfortable talking to other Japanese families who are going through similar situations. Through local Japanese churches, supermarkets, or schools, find out if there are any Japanese support groups in the community. Furthermore, it would be important to remind students that they are not to blame for this crisis, and to help them find ways to channel their energy in a positive manner. For example, encourage students to take part in their healing by organizing an event that can raise awareness or funds. By taking action, they may be able to cope with their feelings.

Ongoing Worldwide Effort

According to correspondence from Dr. Ishikuma on June 9, 2011, Japanese schools have begun to place more value on the role of mental health professionals and are eager to hire an increasing number of such professionals in the affected areas. The government is also showing its support by allocating more funds to hire mental health professionals in the schools. Additionally, Dr. Ishikuma reports that the translated NASP documents have proved to be extremely helpful and many teachers and teacher trainers are beginning to seek more guidance from school psychologists. For example, a staff member from the Miyagi Prefectural Teacher Training Center requested consultation from school psychologists after utilizing NASP documents and finding them to be beneficial. Japanese school psychologists and NASP representatives continue to correspond regularly to support the students, families, and teachers in Japan. Currently they are planning a symposium to be presented at the NASP annual conference in 2012 in order to bring about more awareness and discuss the efforts that have been made and continue to be made to support children at risk due to natural disasters. Although several months have passed since the disaster hit Japan, this correspondence serves as a reminder that the effects of this event are long-lasting; mental health professionals will likely need to reach out to those affected for many years to come. It is our hope that this article has shed some light on our efforts as well as on the Japanese culture, and that this information will prove useful when working with Japanese students and families.


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Maiko Ikeda, NCSP, is a special consultant for the Japanese Association of School Psychologists. Jennifer Saeko Inaba is a school psychologist with the Encinitas Union School District in San Diego, California. Ayako Christina Ikeda is a 3rd year school psychology trainee at SDSU. Miki Kihara is a visiting scholar at the Laboratory of Comparative Human Cognition, the University of California at San Diego.