In the past three decades, there has been a tremendous influx of Chinese immigrants and refugees in the United States. As the largest Asian Pacific American ethnic group, Chinese Americans share many of the same characteristics and values of other Asian Americans, but they also possess their own unique migration history, political background, linguistic styles, and cultural and religious beliefs. This chapter attempts to sensitize clinicians to the complexities and diversity of major Chinese American subcultures, reviews relevant clinical considerations in the treatment of psychological problems, and recommends effective assessment and treatment strategies.
 
HISTORICAL BACKGROUND
 
The Chinese characters for China mean the Middle Kingdom. It has a land mass about 9.6 million square kilometers, which is more than 300,000 square miles larger than the United States. In 1994, the Chinese population in China was 1.192 billion, with a projection of 1.504 billion by the year 2025. The Chinese constitute about one-fifth of all the people on earth. More than 95% of the population live on approximately 40% of the land (Bunge & Shinn, 1981).
 
China has the world's oldest continuous history and culture. (Although there have been earlier civilizations elsewhere, they have flourished and then become extinct.) China's traditional value system is a complex amalgam of ideas that evolved over centuries from the philosophical teachings and religious beliefs of Confucianism, Taoism, Buddhism, and other influences. Social values emphasize the importance of family solidarity, friendship, morality, and conformity of prescribed roles. when the Chinese Communists came to power in 1949, the political revolution also brought along social revolution. Many aspects of traditional social life – social relations, family organization, women's roles, personal values, and so forth – experienced fundamental changes. The industrialization of China in recent years has created another wave of economic and social changes.
 
MIGRATION HISTORY
 
The Chinese migration history to the United States tells a complex yet fascinating story of change, adaptation, and survival. Their experience also reveals how the Chinese family system has been affected by the immense power of political, legal, social and economic forces in the United States and in China (see Table 3.1). The Chinese have been residing in this country in significant numbers for more than 150 years. Major national immigration policies and economic upheavals in the U.S. and in Asian countries have resulted in different waves of immigration and different types of family systems.
 
The First Wave: The Pioneer Family (1850-1919)
 
Although there were Chinese residing in the United States as early as 1785, the impetus for large-scale immigration to this country did not take place until the discovery of gold in California in 1848 and the need for manual labor for the construction of railroads. Many Chinese migrants, mostly peasant farmers, left their village in China to pursue their dreams in Gam Saan, the "Gold Mountain." In addition to employment opportunities, many sought sanctuary from intense conflicts in China caused by the British Opium War and the harsh economic conditions. From their arrival in the 1850s until the 1920s, the overwhelming majority of the early Chinese immigrants were men. More than half of the arriving men were single, and those who were not often were separated from their wives and condemned to live as bachelors in Chinese communities. Racial and ethnic antagonism, coupled with xenophobia against early Chinese immigrants, succeeded in the passage of the Chinese Exclusion Act of 1882. This act barred Chinese laborers and their relatives (including their wives) from entering the United States.
 
The early Chinese pioneers lived in a virtually womanless world without family life. In 1900, of the 89,863 Chinese on the U.S. mainland,