Describes the workings of a weekly psychiatric clinic for Indochinese refugees and the treatment approaches that proved most acceptable to and effective with this population. Established within the Oregon Health Sciences Center’s Indochinese Health Care Project, the clinic trained native Vietnamese, Cambodian, and Laotian counselors to serve the mental health needs of Indochinese refugees; a Vietnamese physician also was recruited as a psychiatric resident. Analysis of the clinical experiences over 2 years revealed difficulty for Indochinese refugees to accept psychiatric referrals, despite great mental distress. This results from both the traditional Asian attitude toward mental illness, involving fear, rejection, and ridicule, and by the lack of a traditional counselor in Asian societies. Some forms of psychiatric treatment, such as questions about feelings and sensitive relationships, seemed threatening to the Indochinese refugee patients. The clinic emphasized the medical approach of the physician, a role familiar to the Indochinese. Emphasis was on taking the patient’s history and reducing his or her symptoms, which has proven to be acceptable to patients.
