This dissertation explored how cultural and religious/spiritual variables affect first-generation Hindu Asian Indian Americans' attitudes and experiences of psychotherapy. This community greatly underutilizes mental health services regardless of need. Acculturation level was investigated as a possible influence. Nine women and four men who were born in India, identified as Hindu, immigrated to the United States at the age of 17 or older, and had been involved in at least three sessions of psychotherapy in the United States participated. Participants were given a demographic questionnaire, the Suinn-Lew Asian Self-Identity Acculturation Scale (SL-ASIA; Suinn, Ricard-Figueroa, Lew, & Vigil, 1987), and a semi-structured interview.

Although participants reported an overall favorable view of psychotherapy, concerns of being stigmatized for receiving mental health services were present in most of the participants' comments. Three quarters of the participants did not want their family to know they were in therapy. Both the stigma of being in therapy and the injunction against going outside the family with private matters, which is a traditional cultural value, influenced their concerns. The worry about stigma was somewhat mitigated by the knowledge that therapy was confidential, and participants highly valued the non-judgmental attitudes of therapists. Having a job and living in the United States were viewed as factors that would incline a Hindu Asian Indian American to need and receive therapy. Both factors created stressors, and a job was thought to provide the means to attend therapy either through benefits or salary.

Being more or less religious did not substantially affect views toward psychotherapy. As a group, participants expressed a high value for the place religion and spirituality had in their lives; however, only four participants believed that spirituality was a necessary component in their treatment. Participants had a tendency to understand spiritual/religious" and "mental" concerns as separate domains.

The types of coping displayed were positive rather than negative; no participants displayed fatalistic beliefs. Higher levels of acculturation were associated with higher numbers of psychotherapy sessions attended, which were a fair indicator of having more favorable attitudes. Participants with higher level of acculturation also had a tendency to prefer a non-Indian therapist.