Cultural Adaptations of Psychotherapy: Therapists’ Applications of Conceptual Models with Asians and Asian Americans

Introduction: Although conceptual models of cultural adaptations of psychotherapy have been developed, little is known about how therapists apply these models in clinical practice. The purpose of this qualitative study was to identify how therapists in the United States (N = 9) and Japan (N = 6) culturally adapt cognitive-behavioral therapy (CBT), one of the most widely used evidence-based approaches, for application with clients of Asian ancestry.

Methods: We anticipated that these therapists would culturally adapt CBT to address common issues identified in the conceptual literature: (a) interdependent conceptualizations of the self; (b) indirect communication; (c) therapist credibility; and (d) gift giving - providing immediate, tangible benefits. A semi-structured, open-ended interview was conducted with each participant.

Results: Qualitative coding of interview transcripts revealed that interdependent conceptualizations of the self and indirect communication were addressed by therapists in both countries and therapist credibility issues were addressed only by therapists in the United States.

Conclusions: These results imply that these elements may be part of what make culturally-adapted interventions more effective than unadapted interventions.