I have tried to divide these articles according to the broader themes, although most articles will fit in more than one thematic area. Byford, Sarah The Use of Dialectical Behavioral Therapy with the Cultural considerations in dialectical behavior therapy Cultural appropriation | Definition, History, Types, & Examples Their original study consisted of individual in-depth face-to-face interviews with patients with psychosis (n = 15) and focused groups with lay members (n = 52), CBT therapists (n = 22) and mental health practitioners (n = 25). Furthermore, individuals might vary in their level of acculturation and religiosity, and this should be taken into consideration (Joseph and DiDuca, Reference Joseph and DiDuca2007). Does clienttherapist gender matching influence therapy course or outcome in psychotherapy? While the authors mention elements of cultural adaptation of the manual, no systematic attempts were made to adapt the manual culturally. Reviewers report that therapists claimed that they practised cultural awareness and were open to discuss culture and were attentive to cultural norms as well as culture-specific expressions of SAD and the level of acculturation. There are multiple arguments in favour of adapting CBT for people from a diverse background (Sue et al., Reference Sue, Zane, Nagayama Hall and Berger2009). CULTURAL APPROPRIATION IS one of the most misunderstood and abused phrases of our tortured age. These adaptations are in line with our current knowledge of cultural adaptations described by other authors in this special issue. Singh, Anneesa D. The principles of CBT underpinned the intervention, with elements of DBT, CFT and ACT. Evidence from fully powered trials will help towards implementation not just in England but in Muslim countries too. So far, the uptake of these interventions into health systems has been low (Naeem et al., Reference Naeem, Rathod, Khan and Ayub2016a). These authors pioneered cultural adaptation of a CBT-based family intervention for psychosis for African-Caribbean people in England, and found it to be feasible and acceptable (Edge et al., Reference Edge, Degnan, Cotterill, Berry, Baker, Drake and Abel2018a,b). It is not common practice to report participants cultural or religious background in CBT research. Many authors have pointed to the uniqueness of military culture as being different from civilian culture, based on routines, structures, hierarchies and the dress codes, among many other attributes (Hall, Reference Hall2011; Reger et al., Reference Reger, Etherage, Reger and Gregory2008; Soeters et al., Reference Soeters, Winslow, Weibull and Caforio2006). View all Google Scholar citations The third article discusses issues of race, cthnicity and culture in CBT to support therapists and service managers to deliver culturally competent therapy (Naz et al., Reference Naz, Gregory and Bahu2019). Huggett, Charlotte This will require establishing trust and partnership with the community. CBT involves exploration and attempts to modify core beliefs. Memon et al. Cultural appropriation, defined Culture refers to the traditions, customs, beliefs, and practices of any given ethnic, racial, or religious group. The authors concluded that if applied thoughtfully, CBT can be used for patients in Saudi Arabia. Estrada, Suzanne They provide best practice guidelines for BME and White therapists, as well as service managers to enable them to work more effectively with service users from different ethnic and cultural backgrounds, for example to consider the current socio-political context. The authors point out that the NICE guidelines do not look at the suitability of cultural adaptations of CBT or how services could be best organized to meet the needs of BME populations. Cultural appropriation They also discuss the integration of ACT and compassion-focused therapy (CFT) in helping this population. Tanzania, like many other low- and middle-income countries, has a long tradition of faith healers (Li, Reference Li2011). There is, however, a need to confirm the effectiveness of culturally adapted family interventions through fully powered RCTs. (Reference Memon, Taylor, Mohebati, Sundin, Cooper, Scanlon and Visser2016) describe factors affecting the relationship between service users and healthcare providers, e.g. It is, however, envisaged that therapists shared the same cultural values as the client, might be mindful of these norms, and possibly delivered therapy in Arabic some vital aspects of cultural adaptation. We are becoming more mindful of the need to equal rights of all members of society, and to all societies and cultures and sub-cultures. It is possible that people presenting with biological symptoms of depression and anxiety attend the modern health facilities, while those with predominantly psychological symptoms or those with a spiritual model of illness, attend faith or religious healers (Naeem, Reference Naeem2013; Naeem et al., Reference Naeem, Phiri, Munshi, Rathod, Ayub, Gobbi and Kingdon2015a). The protocol was developed in a specialist NHS (National Health Service, England) programme for migrants with PTSD. Therapist self-disclosure in cognitive-behavior therapy, Gender equality in Muslim-majority countries, The role of global traditional and complementary systems of medicine in treating mental health problems, The importance of understanding military culture, Culturally Responsive Cognitive-Behavioral Therapy: Assessment, Practice, and Supervision, Internalized stigma among sexual minority adults: insights from a social psychological perspective, Cultural aspects in social anxiety and social anxiety disorder, Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care, Culturally adapted cognitive-behavioral therapy for Chinese Americans with depression: a randomized controlled trial. The authors examined the fidelity and flexibility of treatment elements. They suggest that some BME client groups might test their therapist through initiating TSD. No Comments have been published for this article. This paper describes one of the themes from that study in greater detail, i.e. However, there is lack of evidence supporting this approach with culturally Family intervention reduces hospital admission, encourage compliance with medication, improves general social impairment and the levels of expressed emotion within the family (Pharoah et al., Reference Pharoah, Mari, Rathbone and Wong2010), and therefore is recommended by NICE (NICE, 2014). People of African-Caribbean origin in the UK have a higher incidence of schizophrenia (Fearon et al., Reference Fearon, Kirkbride, Morgan, Dazzan, Morgan, Lloyd and Murray2006), and are less likely to receive psychological therapies (Morgan et al., Reference Morgan, Dazzan, Morgan, Jones, Harrison, Leff and Fearon2006). Peter Phiri and colleagues present findings from a sub-analysis of a qualitative study to culturally adapt CBT for psychosis for people of Afro-Caribbean and South Asian background (Rathod et al., Reference Rathod, Kingdon, Phiri and Gobbi2010). The suggestion that individual variations and environmental factors shape stress response might apply to groups of individuals (Ellis et al., Reference Ellis, Jackson and Boyce2006). It was the very definition of cultural appropriation: when a dominant group of people adopt the customs, practices and ideas of another group of people, often Ghazala Mir and colleagues have very thoughtfully incorporated religious concepts in this intervention, such as self-compassion, hope and taking responsibility for ones actions, and have addressed misconceptions around religious teachings. 2021. Mindfulness-based approaches as practised in the West have also been criticized as either lacking the philosophical, theoretical or theological underpinning (Kirmayer, Reference Kirmayer2015) or even being a tool misused by the capitalist West (Illing, Reference Illing2019). Acceptance and commitment therapy (ACT) is a trans-diagnostic intervention that has been tried both in the West and outside the West. Gender and sexual minorities (GSM) are over-represented in the migrating population. It tells us that the items and beliefs we hold dear and sacred For sexual minorities, minority stress has been implicated as an increased risk of emotional and mental health disorders. The term cultural appropriation is thought to Globalization is bringing people together, and increasing their knowledge and awareness of the latest technologies in healthcare. Andrade, Brendan F. How to Handle Cultural Appropriation: 16 Examples, Next However, they claim that in this case, the cultural context and the broader family system were not the primary factors in the development and maintenance of the problem. The Debate About Cultural Appropriation - O'Neill They suggest more empirical research in this field. However, this will require a two-pronged approach: improving race relations at a national level and working closely with the accreditation bodies and service providers through canvassing, and emphasizing the role social factors play in the management of emotional and mental health problems. Therefore, practical measures to improve access and providing training in culturally adapted therapy might be the most practical way forward. Developed by Linehan Finally, I agree with the authors that this intervention should be used across the board. Sclare, Irene As the author rightly points out, the dearth of CBT studies in this area is troubling. Li, Shirley Xin Brown, June There is a need to improve knowledge of evidence-based therapies through popular electronic and social media, as well as teaching and training health workers. The fourth article emphasizes understanding a clients experience of racism as part of the assessment, formulation and treatment (Beck, Reference Beck2019). Culturally Adapted Dialectical Behavior Therapy in an Andrew Beck starts by presenting evidence that experience of racism can be a cumulative risk factor for developing mental health problems. Note Skerven et al. Culturally adapted dialectical behavior therapy in an } In addition to describing the culturally adapted CBT techniques, the authors highlight the issues of gender discrimination and female sexuality in Muslim countries (Gouda and Potrafke, Reference Gouda and Potrafke2016). Therapists working with traumatized individuals are at increased risk of burnout, compassion fatigue and vicarious trauma (Iqbal, Reference Iqbal2015). The critical incident analysis model consists of a five-stage process: (1) account of the incident, (2) initial responses to the incident, (3) issues and dilemmas highlighted by this incident, (4) learning and (5) outcomes. Religious beliefs about causes and treatment of epilepsy, The Dimensions of Religiosity Scale: 20-item self-report measure of religious preoccupation, guidance, conviction, and emotional involvement, Formulation and treatment: integrating religion and spirituality in clinical practice, Child and Adolescent Psychiatric Clinics of North America, Meta-analysis of the efficacy and acceptability of cognitive-behavioural therapy for Arab adult populations experiencing anxiety, depression or post-traumatic stress disorder. As far as I know, this is the only evidence-based intervention that was adapted for a religious group in England and is being implemented in at least some parts of the service. The authors describe dealing with religious and cultural beliefs, and the role played by the family, engaging family members in therapy, dealing with shame and guilt, and local practices, such as magic rituals. There is evidence to suggest that DBT is an effective treatment (Mndez-Bustos et al., Reference Mndez-Bustos, Calati, Rubio-Ramrez, Oli, Courtet and Lopez-Castroman2019; Panos et al., Reference Panos, Jackson, Hasan and Panos2014). Hudson, Jennifer L. To the extent that the cultural-appropriation police are urging their targets to respect others who are different, they are saying something that everyone needs to hear. Nitty gritty. The subculture of homelessness has been described as the culture of individuals who are homeless and share similar beliefs, values, norms, behaviours, social structures, and a common economic situation, all in response to a comparable living environment (Flaskerud and Strehlow, Reference Flaskerud and Strehlow2008). poor communication, inadequate recognition or response to mental health needs, cultural naivety, insensitivity and discrimination as well as lack of awareness of different services among service users and providers. Stone and Arroll report a qualitative study to explore the experiences of therapists trained in CBT in Tanzania. A systematic review of interventions for treating depression in Muslim patients reported that many studies do not distinguish between beliefs and values that are religious and those that are cultural, and that most of the evidence was methodologically weak or included assertions made without qualification (Walpole et al., Reference Walpole, McMillan, House, Cottrell and Mir2013). The earliest known use of the term cultural appropriation is credited to Arthur E. Christy (1899 1946), a professor of literature at the University of Illinois (Martin, 2018). This paper highlights the need to improve the BME communitys access to CBT. Military personnel share a common bond, feeling of unity and a sense of purpose and direction. interpersonal effectiveness. and Additionally, they have to adjust to the differences in the expression of love, lust and romance. Cultural Appropriation It can be described as the act by a member of a relatively dominant culture of taking a traditional cultural expression and repurposing it in a different context, without authorization, acknowledgement and/or compensation, in a way that causes harm to the traditional cultural expression holder (s). Finally, the authors list available resources in training in military culture for therapists. Cognitive-behavioral treatment of chronically parasuicidal borderline patients, Improving access to mental health care in an Orthodox Jewish community: a critical reflection upon the accommodation of otherness, Perceived barriers to accessing mental health services among black and minority ethnic (BME) communities: a qualitative study in Southeast England, Culturally adapted dialectical behavior therapy in an underserved community mental health setting: a latina adult case study, Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence, Psychotherapy with military personnel: lessons learned, challenges ahead, International Journal of Emergency Mental Health, Adapted behavioural activation for the treatment of depression in Muslims, First episode psychosis and ethnicity: initial findings from the AESOP study, Using cognitive behaviour therapy with South Asian Muslims: findings from the culturally sensitive CBT project, An evidence-based framework for cultural adaptation of cognitive behaviour therapy: process, methodology and foci of adaptation, World Cultural Psychiatry Research Review, Treating unresolved grief and posttraumatic stress symptoms in orphaned children in Tanzania: group-based trauma-focused cognitive behavioral therapy, Cognitive behavioral therapy with Latinos, Meta-analysis and systematic review assessing the efficacy of dialectical behavior therapy (DBT), The effectiveness of a lay health worker led intervention for depressive and anxiety disorders in primary care: the MANAS cluster randomized trial in Goa, India, Effect of a multicomponent behavioral intervention in adults impaired by psychological distress in a conflict-affected area of Pakistan: a randomized clinical trial, A cultural adaptation of dialectical behavior therapy in Nepal, Developing culturally sensitive cognitive behaviour therapy for psychosis for ethnic minority patients by exploration and incorporation of service users and health professionals views and opinions, Cognitive behaviour therapy for psychosis can be adapted for minority ethnic groups: a randomised controlled trial, Belief in supernatural causes of mental illness among Malay patients: impact on treatment, Empirical reality of dialectical behavioral therapy in borderline personality, Civilian psychologists in an army culture: the ethical challenge of cultural competence, Culturally competent adaptation of cognitive-behavioural therapy for psychosis: cases of Orthodox Jewish patients with messianic delusions. The lay counsellors, under supervision, demonstrated high levels of fidelity to the intervention. While egalitarian societies are subtle in acceptance of authority figures, in other societies showing respect for authority is a cultural norm and therefore hard to negotiate. They also discuss the sub-cultures within the army, based on religion, race or gender, etc. Based on this initial research and their clinical experience, and in order to further improve strategies to improve therapeutic alliance and engagement, they discuss TSD in this article. The results of the qualitative analysis found five superordinate themes: the medical model, novelty, practicalities, process and therapist effects. Similarly, researchers do not record information concerning participants sexual orientation (Bowen and Boehmer, Reference Bowen and Boehmer2007). Most adaptations involved modifications to language, metaphors, methods, and context. Conclusions: Culturally adapted DBT has been implemented and accepted among several racial, ethnic, and cultural groups, although there is insufficient evidence to determine whether culturally adapted DBT is more efficacious than nonadapted DBT. Orthodox Jews and Muslims (Kada, Reference Kada2019; Mir et al., Reference Mir, Ghani, Meer and Hussain2019). Therapy was adapted using qualitative methods while maintaining the theoretical underpinning of BA and was found to be feasible and acceptable (Mir et al., Reference Mir, Meer, Cottrell, McMillan, House and Kanter2015). The second article describes an evaluation of the transition from the Black, Asian and minority ethnic (BME) community mental health worker to the IAPT low-intensity psychological wellbeing practitioner (Hakim et al., Reference Hakim, Thompson and Coleman-Oluwabusola2019). While frameworks in the past were based on therapists personal experience, these authors have described a systematic approach to culturally adapt CBT that is based on evidence and has been tested through RCTs. Harmful Effects of Cultural Appropriation - Health WebMaybe the differences would be that FAP makes a greater emphasis in the disclosing of therapists reactions as a way to evoke and reinforce clients desirable actions, while DBT They also highlight the culturally sensitive practice of involving faith or religious healers in therapy (Kada, Reference Kada2019; Mir et al., Reference Mir, Ghani, Meer and Hussain2019; Naeem et al., Reference Naeem, Phiri, Munshi, Rathod, Ayub, Gobbi and Kingdon2015a). The group intervention reduced depression, anxiety and emotional distress. for this article. As far as I know, this is the first paper to address TSD in a cultural context. Therapists often do not discuss service users experiences of racism. Three papers (d) focus on refugees, asylum seekers and the homeless. The authors considered adaptations at numerous levels. Hagler, Matthew A. WebLA-based artist Sam Durant made headline news in the summer of 2017 when his piece, Scaffold (2017), was exhibited at the Walker Art Centers sculpture park in Minneapolis, Minnesota and was subsequently protested by the Dakota community as a crime of historical violence and racial traumatization.Scaffold was originally installed in 2012 in Bertie, Lizl-Antoinette "useRatesEcommerce": false In this thought-provoking article, the authors argue that attempts to culturally adapt interventions for Black and Minority ethnic (BME) service users will not have the desired impact if sufficient measures are not in place to improve access to psychological services. It makes common sense that experienced health professionals regardless of their background can offer extra advantages to their service users if they transition to the IAPT. It is therefore surprising that only limited literature is available on the adaptation of psychotherapy with military personnel (Miller, Reference Miller2010; Spoont et al., Reference Spoont, Sayer, Thuras, Erbes and Winston2003). The idea of therapist matching has been a topic of debate; however, research in this area has reported mixed results (Flaskerud, Reference Flaskerud1990; Lambert, Reference Lambert2016). The authors used thematic analysis to further elaborate on critical elements of this theme and how this could impact on (a) therapists reaction towards TSD, (b) the therapeutic alliance, and ultimately (c) the outcomes of therapy. The prevalence rates of mental health difficulties among UASC are understandably higher than among children seeking asylum with their families, or children who are not from refugee or asylum-seeking backgrounds. This approach is supported by the World Health Organization (WHO) as depicted in mhGAP (WHO, 2015), which promotes scaling up of evidence-based interventions and emphasizes the role of lay counsellors in delivering these interventions directly to the community members. I also suggest that authors should consider replication of this model in other countries, especially non-Western countries. Kenneth Fung has reported high levels of acceptance of ACT while working with the Cambodian community in Toronto (Fung, Reference Fung2015). Dialectical Behavioral Therapy (DBT) - Healthline Followed by their pioneering work, more studies have been published from Tanzania (ODonnell et al., Reference ODonnell, Dorsey, Gong, Ostermann, Whetten, Cohen and Whetten2014; Woods-Jaeger et al., Reference Woods-Jaeger, Kava, Akiba, Lucid and Dorsey2017). Engaging local mental health professionals can play a vital role in this regard to understand the ground realities, rather than taking a public health approach. client initiated therapist self-disclosure (TSD). emotional regulation. The original Beckian CBT model has been adapted over the years to help service users with anxiety, PTSD, OCD and psychosis. WebCultural appropriation is the act of adopting elements of an outside, often minority culture, including knowledge, practices, and symbols, without understanding or respecting the original culture and context. Collectively, papers in this special issue provide us with sufficient evidence that cultural considerations play a vital role when using CBT, offer practical suggestions for improving cultural competence and most importantly, can catalyse future research. Arun, whites would never claim cultural appropriation. Total loading time: 0 The dissociative responses are explained using the 6 Fs cascade. Chan, Ngan Yin Didactic adaptations focused on improving engagement and included the use of audiovisual material. pause before claiming cultural Both the cultural adaptation of CBT that focuses on differences across cultures and a universalist approach focusing on similarities across cultures merit further investigation. Ghazala Mir and co-workers have culturally adapted behavioural activation (BA) for Muslim service users in England. WebDBT is an intervention that has demonstrated efficacy for reducing suicidality (Swales et al., 2000), which may be effective among Native American clients. Ho, Pin-Cheng This intervention was planned around three key themes: physical health needs, emotional wellbeing, and resilience-building. Despite very high rates of mental health problems and suicidal behaviours, the LGBTQ+ community faces numerous barriers in accessing mental healthcare (Veltman and Chaimowitz, Reference Veltman and Chaimowitz2014). This Ca-CBTp was found to be feasible and acceptable as well as effective in a pilot RCT (Rathod et al., Reference Rathod, Phiri, Harris, Underwood, Thagadur, Padmanabi and Kingdon2013). Seven participants from Tanzanias only psychiatric hospital who had completed CBT training were interviewed. When working cross-culturally, many consider a universalist approach to help focus on the similarities across cultures, rather than emphasizing differences (Beck, Reference Beck2016). Most importantly, a focus on the implementation of adapted CBT, service development and improving access to adapted CBT is required, which can only happen with building the evidence base and advocacy for the right to evidence-based care. Therefore, for CBT to stay in the system, it has to evolve, to adapt and even integrate other systems of therapies, in order to address the demands of people with a variety of needs. Stallard, Paul Carter, Ben This systematic review reports case studies, as there were no randomized controlled trials (RCTs) in this area. Authors are encouraged to further this work by developing a manualized intervention that can be tested through experimental research. Therefore, sensitive use of TSD considered to be a useful tool (Goldfried et al., Reference Goldfried, Burckell and Eubanks-Carter2003) becomes even more critical when working with BME communities. They describe some examples from their work to show how the services can better understand the needs of minority populations. It is heartening to see this field grow over the past decade to the extent that it found its place in a special edition of a highly prestigious journal. Lisk, Stephen Finally, this special issue publishes seven articles (f) on issues related to service delivery, practice, training and supervision when working with a diverse population. Published online by Cambridge University Press: Authors describe a staged process of culturally adapting CBT that takes into account stakeholders opinions and experiences to develop guidelines that can be used to adapt CBT for clients from a non-Western background culturally. This paper reports the cultural adaptation of ACT for the Turkish-speaking community in England. Farrelly, Maria distress tolerance. Currently, a quantitative evaluation is underway. We encourage the authors to share in-depth details of adaptations for application across countries and cultures. Another survey from Canada reported time spent with trauma victims to be the strongest predictor of the traumatic stress. The authors discuss the impact of minority stress, shame and migration stress in this group.
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