The aim of the present study was to document clinicians' and community members' perspectives on the cultural adaptation of cognitive-behavioral therapy (CBT) to Chinese migrants with depression. Thirty-four participants, recruited using snowballing and purposive sampling, participated in 12 individual semistructured interviews and 5 focus groups. Thematic analysis and a modified consensual qualitative research approach were used for data analysis. Five major themes were identified: mixed attitudes and perspectives toward CBT, improving the cultural sensitivity of cognitive restructuring, applications of behavioral strategies, attitudes toward mindfulness meditation, and the importance of incorporating core culturally sensitive strategies. The findings suggest that a client's interdependent self needs to be considered in future versions of CBT for Chinese migrants. In terms of therapy, this would involve an equal emphasis on adopting a culturally sensitive approach in using cognitive, behavioral, and focus techniques and cultivating cultural humility. As such, a key challenge for clinicians is to shift their clinical perspective from one of cultural competency (i.e., developing culture-specific expertise) to cultural humility (i.e., learning from clients about their culture and worldviews instead of assuming expertise). An emphasis on cultural sensitivity has the potential to improve clinical engagement and treatment outcomes of psychological interventions in an underrepresented population in counseling services.
Public Significance StatementThe present study advances the idea that a client's interdependent self needs to be considered in future versions of cognitive-behavioral therapy for Chinese migrants. In practice, this would involve an equal emphasis on cognitive, behavioral, and focus techniques and cultivating cultural humility.