Aboriginal Practitioners Offer Culturally Safe and Responsive CBT: Response to Commentaries

Abstract

We appreciate the valuable commentaries that have been provided for our paper "Can CBT be effective for Aboriginal Australians? Perspectives of Aboriginal practitioners trained in CBT." The international authors identify how CBT, with adaptations by culturally responsive practitioners can be of value for non-Western and Indigenous peoples. The commentary by Australian psychologists Dudgeon and Kelly questions the value of CBT for Indigenous Australians, terming it a "Western therapy" that is "culturally unresponsive" and "culturally blind." They also critique the methodology of the study. We argue that CBT can be adapted by culturally competent practitioners to be culturally safe in Australia, as elsewhere. Cultural safety is mostly a function of the therapist, not the therapy. In the Bennett-Levy et al. (2014) study, CBT was delivered in a culturally responsive way by Aboriginal counsellors within their own communities. CBT is a particularly adaptable and versatile therapy, and embodies principles of empowerment and self-determination that are central to Indigenous social and emotional well-being. We are concerned that CBT, which has strong empirical support and has been adapted elsewhere for a range of cultures, including Indigenous cultures, may be being denied to Indigenous Australian clients. There is considerable opportunity to evaluate the effectiveness and versatility of CBT, and variations of its mode of delivery, for all Australians.

Cultural Competence in Clinical Psychology Training: A Qualitative Investigation of Student and Academic Experiences

“…While acknowledging the efforts made by their universities to address cultural issues, students struggled to apply their “western” knowledge and practices when working with Aboriginal and Torres Strait Islander clients, or with clients from other cultural groups, such as Asian clients. Participants’ experiences of clinical psychology as “western” ethnocentric are consistent with other Australian and international literature (Ford, ; Henrich, Heine, & Norenzayan, ; McConnochie et al, ; Nelson et al, ; Ranzijn et al, ; Vicary & Bishop, ; Walker & Sonn, ).…”

“…This raises concerns about the applicability of these "western" models in multicultural settings, especially in Indigenous contexts (e.g., Ford, 2013;McConnochie, Ranzijn, Hodgson, Nolan, & Samson, 2012;Ranzijn, McConnochie, Clarke, & Nolan, 2007;Vicary & Bishop, 2005). Consequently, psychologists need to culturally adapt the practices of clinical psychology (Khawaja, McCarthy, Braddock, & Dunne, 2013;Nelson et al, 2014;Ranzijn et al, 2007) in order to provide "cultural safety" when practicing cross-culturally (Walker & Sonn, 2010). Cultural competence is thus an essential attribute of clinical psychologists in Australia.…”

The Prevalence of Cognitive Impairment among People Attending a Homeless Service in Far North Queensland with a Majority Aboriginal and/or Torres Strait Islander People

“…It is important that counselling and support programs offered to Aboriginal and/or Torres Strait Islander people are culturally sound (Nelson et al, 2014;Vicary & Bishop, 2005 This study has limitations that are important to consider when interpreting the findings. This was the first study-to the knowledge of the authors-to explore the prevalence of cognitive impairment across a homeless cohort including a majority of Aboriginal and/or Torres Strait Islander people.…”

“…It is important that counselling and support programs offered to Aboriginal and/or Torres Strait Islander people are culturally sound (Nelson et al, ; Vicary & Bishop, ). Where Australian homeless populations include a high proportion of Aboriginal and/or Torres Strait Islander people, support programs would benefit by taking guidance from the resource Working together: Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and Practice (hereafter Working Together) (Purdie, Dudgeon, & Walker, ).…”

The Australian Psychological Society's Apology to Aboriginal and Torres Strait Islander People

“…Intervention. Further research has addressed the treatment of mental health problems including the appropriateness of prevailing treatment paradigms and frameworks, such as cognitive‐behavioural approaches (Bennett & Babbage, ; Bennett‐Levy et al, ; Hays, ; Kilcullen, Swinbourne, & Cadet‐James, ), cultural safety and responsive treatment (Nelson et al, ), e‐mental health (Dingwall, Puszka, Sweet & Nagel, 2015) variables to consider for intervention research with Aboriginal Australians (Dudgeon & Kelly, ).…”