Transcultural adaptation of cognitive behavioral therapy (CBT) in Asia

Abstract

Background Cognitive behavior therapy (CBT) is an evidence based therapy and is now recommended by national organizations in many high income countries. CBT is underpinned by the European values and therefore for it to be effective in other cultures it needs to be adapted. Aims This paper describes an evidence based approach to culturally adapt CBT in Asian context, areas of focus for such adaptation and lessons learned. Methods An environmental scan of the literature, description of local CBT associations and perspectives from these organizations. Results Cultural adaptation of CBT focuses on three main areas; 1 awareness of culture and related issues, 2 assessment and 3 adjustment in therapy techniques. Conclusions The last decade has seen an increase in culturally adapted CBT in Asia, however, more work needs to be done to improve access to CBT in Asia.

Cultural adaptation of cognitive behaviour therapy for depression: a qualitative study exploring views of patients and practitioners from India

“…Targeting and addressing core beliefs are rarely possible in brief therapy as highlighted by therapists. Patients from Asian cultures often find behavioural methods like behavioural activation, behavioural experiments and problem-solving particularly useful (Naeem et al ., 2021). Interviews from patients in the present study highlighted that the techniques they found beneficial included behaviour activation, education about cognitive distortions, and restructuring techniques like perspective taking exercise, worst/best, and realistic scenario.…”

“…Patients from Asian cultures often feel uncomfortable during questing or deciding for themselves. Therapists are supposed to offer guidance or answer to clients' problems (Naeem et al, 2019;Naeem et al, 2021). Similarly, it was also mentioned that clients in Asian cultures expect the therapist to take on an authoritative role.…”

Effects of Group and Individual Culturally Adapted Cognitive Behavioral Therapy on Depression and Sexual Satisfaction among Perimenopausal Women

“…As suggested by Azhar and Varma [ 44 ], an adaptation of CBT among the Muslim population is necessary for treatment to be effective. As in any other psychotherapy, CBT is value-laden, which involves the exploration of core beliefs and unhelpful patterns of thinking and attempts to modify them [ 42 , 45 , 46 ]. Hays and Iwamasa [ 47 ] suggested that religion and spirituality definitions, prejudice and political background, linguistic levels and cognitive style, family structure and gender role assignments, collectivistic orientations, and health belief perspectives are among the relevant culture-specific variables.…”

“…Moreover, CBT, which is short-term, focused, cost-effective, and evidence-based, has been culturally adapted in different continents. In a recent review of meta-analyses of culturally adapted interventions, we found that CBT was the most commonly used culturally adapted therapy [ 46 ]. While there is a large empirical support for CBT as an effective intervention for treatment of depression [ 49 ], there is limited research on the effectiveness of CA-CBT for treatment of depression and sexual satisfaction among Iranian women in menopausal transition [ 46 , 50 ].…”

“…In a recent review of meta-analyses of culturally adapted interventions, we found that CBT was the most commonly used culturally adapted therapy [ 46 ]. While there is a large empirical support for CBT as an effective intervention for treatment of depression [ 49 ], there is limited research on the effectiveness of CA-CBT for treatment of depression and sexual satisfaction among Iranian women in menopausal transition [ 46 , 50 ]. Considering the fact that culture has a fundamental influence on shaping attitudes, values systems, and points of view toward sex, it is essential to have a culturally adapted CBT as suggested by Hays and Iwamasa [ 47 ].…”