National Center for Effective Mental Halth Consultation

Activity: Gathering Information with the Culturagram as a Guide -
Chloe Huan

Save or print a copy of the Culturagram for the activity that follows.

Review the vignette below and use the Culturagram as a guide to identify what information has been gathered, where further exploration would be valuable, and in what areas, if any, no information has been gathered.

Vignette - Chloe Huan

My name is Dr. Jackie Lawson, and I am a mental health consultant working with an Early Head Start program in a community that includes both an air force and army base in California. The program serves about 30 families – including families who are immigrants, young military families, and native Californians. There are a number of foreign born spouses of GIs that are enrolled in the program who are somewhat isolated from their families and are also dealing with the stresses of having a spouse that is deployed overseas.

I come from a small rural community in the San Joaquin valley, near the foothills of the Sierra Nevada mountains. My training as a psychologist included an internship in the heart of Los Angeles, working with primarily Latino families; my first professional interaction with people of cultures other than my own. Since taking this job, I have had to learn a lot quickly about working with families who are from many different countries and communities, including the military community. I believe that I work well with program staff, including administration, and I take time to learn from the families who participate in the program. I enjoy my work in the special First-Time Mom's military initiative to engage and support women whose husbands are away.

Chloe Huan is a first time, expectant mother married to an American GI, deployed to Afghanistan. Her husband, Brett has been away for eight months, and Chloe has had a hard time with the separation. Chloe is a second generation Chinese immigrant whose parents live in Hawaii. Brett's family is local and has been supportive to her throughout her pregnancy. Over the past six months Chloe and I have built a solid relationship based upon telling each other “our stories”, and working on some issues common to military spouses (i.e., loneness, isolation, managing the stresses of being away from loved ones, finances, navigating the military health care systems, etc.), as well as her preparing to be a mother.

I have learned about negotiating cultural differences from Chloe who has dealt with her in-laws differing cultural beliefs and practices about pregnancy, and childbirth. For example, three months ago Chloe lost a cousin-in-law to breast cancer, and while she grieved privately, she grappled with traditions that dictate that pregnant Chinese women should make every effort to stay away from funerals. While Chloe wanted to pay her respects and show her in-laws support, she would not be able to tell her parents that she had broken with cultural norms. She attended the funeral, but carried a great sense of guilt and worried constantly about the health and well-being, and eventual disposition of her unborn child because of her decision. Again, Chloe's cultural beliefs informed her that child's personality traits would be strongly influenced by her state of mind, and body while expecting.

Chloe and I have spoken at length about Chinese practices for naming babies, special foods to be eaten during pregnancy, and those to avoid; Tai Chi for relaxation and focus; as well as Chloe's dreams and hopes for her unborn baby and how much she looks forward to her husband's safe return. Chloe does not yet know the sex of her child as her mother shared several family beliefs (that some might call superstitions) about learning the baby's gender and speaking the baby's name before it is born, and the bad luck that may follow.

Though at a distance, Chloe's mother and father have been very supportive and are very excited about the impending birth of their first grandchild. They look forward to helping Chloe, Brett, and Brett's parents to raise their grandchild in a blended, bi-cultural family, all the while instilling Chinese customs and traditions. Chloe's parents planned to come to California one month before the baby's birth and to stay for a little over a month in a half to assist her with the baby. Their plans were postponed because Mr. Huan had to have emergency heart surgery, and it could be awhile before he receives the doctor's okay to fly the long distance from Hawaii.

Chloe and I have spoken so frequently and shared so much that I was unprepared for her sudden disappearance just around the time of her due date. Phone and email messages that I left for her went unanswered and unreturned and no one at the Early Head Start program had seen Chloe in five to ten days. I began to wonder whether her father's health could have caused her to go to Hawaii, or if she were ill herself. Not wanting to rush to a conclusion or to cause undue concern, I decided against calling the police, but did call the base hospital to see if she’d delivered her baby, but Chloe Huan was not a registered patient. At the beginning of the second week of her disappearance, the center called me with a message from Brett’s sister Pam asking me to call her. I was able to reach Pam, who apologized for not connecting with me sooner, but wanted me to know that Chloe was safe and that Joshua Huan Armstrong had been born ten days ago.

I had to stop myself from saying what I was thinking: What happened that Chloe had not called me? Had I said or done something wrong or that offended her the last time we spoke? What had I missed in all of our conversations? I felt somewhat relieved when Pam told me that Chloe had received a special gift from her parents for her “Zuo Yuezi or sitting the month”. Sitting the month I thought? I had never heard of that and asked Pam about it. She explained it as a cultural postpartum custom that provides birthing assistance, comprehensive holistic care for the newborn and mother, and a network of services to support a family after the birth of a child for forty days. Chloe's son was born in a Zuo Yuezi birthing center in the Chinatown area of Los Angeles.

I have to admit that I was glad to hear that Chloe and the baby were safe, but I still felt confused about the tradition, the lack of communication, and the fact that Chloe had never shared this information with me.  When Pam offered me Chloe’s phone number, I called to express my happiness for Chloe and her newborn son.  Chloe explained that she had never heard of the custom before she received the unexpected gift of a driver at her door and perfectly timed call from her parents to explain the tradition and the surprise that awaited her. Given Mr. Huan’s health, her husband being deployed, his family being of a different cultural background, and her parent’s strong desire to keep tradition, this was the best gift that they had to offer.

(Babyzone, (2011); Doufu, C. (2011); Pregnancy and Newborn (2011))


Gathering Information Questions

  1. Using the Culturagram as a guide:
    • What information has been gathered?
    • In what area would further exploration have been valuable?
    • What information, if any, is missing?   
  2. What are some of the interpersonal approaches that Jackie in her role of mental health consultant used to get to know Chloe, her history, present circumstances, culture, customs, and practices?
  3. Think of all of the cultural information that Jackie learned from Chloe. Is there anything that she might have done to learn more about Chinese pregnancy traditions so that the custom of “sitting the month” may not have come as such a surprise?

Possible Answers Click here for more:




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