Cognitive-Behavioral Therapy With Chinese Americans: Research, Theory, and Clinical Practice
Section snippets
Chinese Americans and Mental Health
According to the 2000 census, there are approximately 12 million Asian Americans in the U.S., with people of Chinese ancestry comprising the largest group (2.7 million) (Barnes & Bennett, 2002). As a whole, Asian Americans are the fastest growing ethnic group in the U.S. and it is projected that their numbers will quadruple by the year 2050. While there are many similarities among the 43 ethnic groups encapsulated under the pan-ethnic label of “Asian American” (Lee, 1998), it is important not
Treatment Studies
To our knowledge, no randomized controlled trials examining the efficacy of CBT or other ESTs have been conducted on Chinese Americans. This gap in the literature is reflected by reviews of the overall treatment literature on Asian Americans, which tend not to differentiate among the different Asian ethnic groups, and are limited to descriptions of naturalistic treatment outcomes. The extant literature indicates that Asian Americans are less likely than other ethnic groups to seek treatment (
CBT and Chinese Americans
Chinese American mental health scholars have hypothesized that CBT may be more compatible with Asian culture and belief systems than other therapies (Lee, 1997b, Leong, 1986; Y. Lin, 2001). Although this belief has yet to be empirically tested, CBT seems to be one of the more popular treatment approaches used to treat clients of Chinese descent (Y. Lin, 2001) and may be preferred over psychodynamic approaches because it is more structured, directive, and symptom focused (Hong & Ham, 2001).
For
Case Study
Billy, a 12-year-old Chinese American male, was referred to a university mental health clinic by his pediatrician and child neurologist after experiencing 2 weeks of medically unexplained retrograde amnesia, drop attacks, and apparent loss of consciousness for several minutes followed by confusion and agitation lasting an hour. A drop attack is a medical symptom—not a diagnosis—involving a sudden spontaneous fall while standing or walking. In most American patients, drop attacks are not
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2022, Cognitive and Behavioral PracticeCitation Excerpt :This particular outcome is a complex one, in terms of its utility. On one hand, diverse communities have been siloed and examined separately under the understanding that the differences between these groups are too great to appreciably examine them all together, resulting in several community-specific treatment frameworks (Bernal et al., 2009; Hwang et al., 2006; Wood et al., 2008). On the other hand, it is this very separation of diverse communities that has perpetuated health disparities because often the individual numbers of diverse communities are so much smaller that their needs and requirements are not structurally addressed (Chou et al., 2012; Hatzenbuehler et al., 2017; Sibrava et al., 2019).
Adaptation of Transdiagnostic CBT for Turkish Adolescents: Examples From Culturally Adapted Multiplex CBT
2019, Cognitive and Behavioral PracticeCitation Excerpt :By assessing the TSSA items and by informing the patient that the symptoms will improve, the patient knows the treatment will address key areas of concern, which increases positive expectancy. To promote positive expectancy, we also use analogies of CBT processes to local practices, a form of explanatory model bridging (Hinton & Jalal, 2014a; Hinton, Lewis-Fernández, Kirmayer, & Weiss, 2016; cf. Hwang, Wood, Lin, & Cheung, 2006, proposed as cultural bridging; Jalal, Samir, & Hinton, 2016). As one example of using such bridging analogies, in multiplex CBT, treatment is compared to the making of a special local dish that involves multiple culinary steps in order to promote positive expectancy and to teach patience about the time frame of improvement.
Adaptation of CBT for Traumatized South African Indigenous Groups: Examples from Multiplex CBT for PTSD
2018, Cognitive and Behavioral PracticeCitation Excerpt :For instance, one should explain that the symptoms experienced that are labeled as “having problems with the head” are not due to bewitchment or curses but rather to anxiety and depression, thereby normalizing the disorder. Another way to normalize the treatment and create positive expectancy is to do explanatory model bridging by such means as depicting CBT principles in terms of locally salient practices, metaphors, proverbs, and analogies (Figure 4; Hinton & Jalal, 2014b; Hinton, Lewis-Fernández, Kirmayer, & Weiss, 2016; Jalal, Samir, & Hinton, 2017; cf. to cultural bridging as proposed by Hwang, Wood, Lin, & Cheung, 2006). Explanatory model bridging is a key aspect of cultural grounding of CBT (Hinton & Jalal, 2014b; Hinton, Lewis-Fernández, Kirmayer, & Weiss, 2016; Jalal et al., 2017).
Culturally Sensitive Adaptations to Evidence-Based Cognitive Behavioral Treatment for Social Anxiety Disorder: A Case Paper
2017, Cognitive and Behavioral PracticeAdaptation of CBT for Traumatized Egyptians: Examples from Culturally Adapted CBT (CA-CBT)
2017, Cognitive and Behavioral PracticeCitation Excerpt :Another way to normalize the treatment and create positive associations and expectancy about the treatment is to provide certain descriptions of the entire treatment and about its specific elements, and to ground them in terms of locally salient practices and metaphors, what may be called “cultural grounding.” Doing so might involve using bridging analogies or bridging metaphors in the service of explanatory model bridging (cf. to cultural bridging as proposed by Hwang, Wood, Lin, & Cheung, 2006; see Figure 1). For example, in CA-CBT, treatment is compared to the making of a special local dish that involves multiple culinary steps in order to promote positive expectancy and to teach patience about the timeframe of improvement.
Ethnic differences in the effectiveness of cognitive behavioral therapy combined with medication: Comparing Asian American and white psychiatric patients
2016, Asian Journal of PsychiatryCitation Excerpt :Sue et al. (2012) finds a gap in what is known about the mental health status and psychotherapy treatment of the Asian American population. As CBT is directive, short-term, and action-oriented, it is thought to be culturally congruent with Asian clients’ expectations of therapy (Hong and Ham, 2001; Hwang et al., 2006). A recent study (Tang et al., 2015) found CBT combined with medication to be an effective treatment for Asian American (AA) patients within an acute psychiatric partial hospital setting.