Hwang - Culturally adapting psychotherapy for Asian heritage populations: an evidence-based approach

1. Figures in Chapter 3

Wei-chin Hwang

Claremont McKenna College, Claremont, CA, United States

Independent Clinical Psychological Practice, Pasadena and Claremont, CA, United States

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This book is about culturally adapting psychotherapy and learning how to individualize therapy for diverse populations. In covering this topic, a primary focus of this book is placed on developing a broad and comprehensive understanding of how to culturally adapt psychotherapy for diverse populations, immigrants, and ethnic minorities. Many of the models, frameworks, and principles that I will discuss will be broad enough that they can be readily applied and will have general clinical utility with many different groups. However, the central focus of this book will be on developing a deep structural understanding of how to culturally adapt psychotherapy for Asian heritage populations. The goals are to help practitioners, researchers, and scientist-practitioners alike develop an intuitive understanding of cultural adaptations both broadly and deeply.

There are many books out there that discuss culturally competent treatment for diverse populations, and that provide separate chapters covering different racial or ethnocultural groups. Although this can be advantageous because it allows for breadth of understanding, they often leave readers with a superficial or stereotyped understanding of how to work with specific populations. Practitioners who want and need cultural competency are often left wondering what to actually do and what to say when they are working with diverse populations in the therapy room. They are often unsure of how to utilize the general or stereotyped information provided in a concrete and specific manner.

This book is different because the central focus is on providing practical, concrete, and clinically useful strategies that will help practitioners improve their clinical-cultural skills. The books emphasis is on culturally adapting psychotherapy for Asian heritage populations, a racial group consisting of many different ethnicities and national origins. It is important to note that there are many similarities across Asian groups, as well as many differences. A lesser focus is placed on understanding each and every one of these different Asian groups, while a greater focus is placed on understanding some of the similarities that cut across Asian heritage populations. A culturally competent therapist is a person who not only possesses concrete and specific knowledge about different cultural groups, but also understands how to think critically about the complex interplay of cultural and clinical issues. Specifically, they are able to take generic or stereotyped information, understand the broader context, while still being able to individualize therapy for the client. A culturally competent therapist is also able to process information and utilize a flexible mindset and framework to improve their ability to engage clients, improve therapeutic relationships, and be clinically effective. They are also cognizant to their own cultural biases, and possess a certain level of cultural self-awareness.

This book is also different from other books in that it provides the reader with an evidence-based and culturally adapted treatment manual that has been tested in a randomized controlled trial (RCT). As part of this book, the reader is provided with a culturally adapted and evidence-based 12-session treatment manual that was specifically developed for treating depressed Chinese Americans. This manual was developed using a community-participatory approach and tested in a clinical trial in San Francisco and Los Angeles. This RCT was funded by a R34 grant that I received from the National Institute of Mental Health (From Intervention Development to Services: Exploratory Research Grants) entitled Adapting Cognitive Behavioral Therapy (CBT) for Chinese Americans, which tested the Culturally Adapted CBT (CA-CBT) with CBT. It is important to note that even though the manual is a cultural adaptation of CBT, many of the cultural adaptations and therapeutic interventions utilized are not restricted to CBT. Specifically, when developing the cultural adaptations, I tried to develop cultural adaptations and modifications that would be effective, and that can cut across and be readily utilized when providing treatments of different therapeutic orientations and modalities.