Cultural adaptations of psychotherapy: Therapists’ applications of conceptual models with Asians and Asian Americans.

Abstract

Although conceptual models of cultural adaptations of psychotherapy have been developed, little is known about how therapists apply these models in clinical practice. The purpose of the current study was to examine, using a directed content analysis, how therapists culturally adapt cognitive-behavioral therapy, one of the most widely used evidence-based approaches, for application with clients of Asian ancestry. The study also examined if there were major differences in adaptation strategies between therapists who practice in the United States (N ϭ 9), a predominantly individualistic society, as opposed to those who practice in Japan (N ϭ 6), a predominantly collectivistic society. Semistructured, openended interviews revealed that interdependent conceptualizations of the self and indirect communication were addressed by therapists in both countries, and therapist credibility issues were addressed only by therapists in the United States. These results imply that when culturally adapting psychotherapy, therapists incorporate elements of conceptual models that are relevant to their clients' cultures. What is the public significance of this article?This study suggests that therapists in the United States and Japan culturally adapt psychotherapy for their Asian clients. These adaptations may make psychotherapy more relevant to clients from diverse cultural backgrounds.

Utilizing Cognitive Processing Therapy to Treat Sexual Trauma with a Pakistani-American: A Case Report

“…The first author taught a skill and then encouraged and empowered her to use the skill and come to conclusions about her stuck points on her own. This style was consistent with recommendations from the literature regarding directive and collaborative style of therapy with PA patients (Hall et al, 2018;Naeem et al, 2015). The first author frequently reminded her the goal of CPT is to "become your own therapist" (Resick et al, 2017, p. 23).…”

“…They tend to feel uncomfortable if SD is used without sufficient preparation (Irfan et al, 2017). Additionally, AAs collectively underutilize mental health services more than any other group relative to their representation in the population (Hall et al, 2018). Further, AAs are more likely to have higher rates of premature termination and attend fewer treatment sessions than European Americans (Owen et al, 2012).…”

“…Below is the first author's perspective and approach to managing the therapeutic dynamic through the lens of diversity. Hall et al (2018) emphasized two broad goals and issues to address for therapists working with AA patients: (a) creating a therapeutic alliance and (b) engagement in treatment. To facilitate a higher likelihood of this occurring amongst AA patients, Ibarki and Hall (2014) argued for Ethnic Matching (EM), a concept described as pairing patients and therapists with a shared ethnic background.…”

“…The first author hypothesizes this is due to Ms. Smith's openness to a non-EM therapist and their commitment to open dialog throughout treatment about diversity-related issues. Fostering a strong therapeutic alliance helps AA patients become more engaged in treatment (Hall et al, 2018). Therapist credibility builds the patient's trust in the therapist's expertise.…”

A Systematic Narrative Review of Cognitive-Behavioral Therapies with Asian American Youth

“…Core features of CBT include its structured, and often manualized, nature (Hall et al, 2019) and the directive approach of CBT therapists (e.g., providing psychoeducation, assigning homework; Hwang et al, 2006). Scholars suggest that structured interventions may be more acceptable and engaging for AsA youth (Sandil, 2006) and that AsA might be especially inclined to complete between-session assignments (Iwamasa et al, 2019;Sandil, 2006).…”