cognitive behavioural therapy in a cross cultural … · suitability of cross‐cultural population...

COGNITIVECOGNITIVE‐‐BEHAVIOURAL THERAPY BEHAVIOURAL THERAPY IN A CROSS CULTURAL IN A CROSS CULTURAL

CONTEXT: What Works?CONTEXT: What Works?

Jayanthi Sundararaman, MAPsS, Associate UNSW

Copyright ©2008 J.Sundararaman

CBT in a Nutshell

What is Cultural Sensitivity?

The Two Basic Elements: Therapeutic Content and Process

Discussion

COGNITIVECOGNITIVE‐‐BEHAVIOURAL THERAPY IN A BEHAVIOURAL THERAPY IN A CROSS CULTURAL CONTEXT: What Works?CROSS CULTURAL CONTEXT: What Works?



What is CulturalSensitivity?

Classical Conditioning Principles

Operant Conditioning Principles

Behaviourism

Learned Helpnessness(Seligman)

Cognitive Develpmental Model(Guidano & Liotti, 1983;Mahoney, 1991,1995)

Beck’s Cognitive Model

REBT

(Ellis)

Social CognitiveTherapy(Bandura)

Schema Therapy (Young))

(SIT

Meichenbaum)

Cognitive Theories

CBT


Encoding BiasesEncoding Biases

Interpretation BiasesInterpretation Biases

Retrieval BiasesRetrieval Biases

INPUT

Hey that is not fair! Heuristics also serve lots of useful purposes!!

OR

Pathological Heuristics


Increase Self‐Awareness

Increase Coping Strategies

Decrease Emotional Distress

Decrease Maladaptive Behaviours

Develop Habits of Constructive Thinking

CBT Goals for the Client


Therapist Client



General content of therapy (some samples only)

Psycho‐education

Self‐Monitoring

Relaxation Training

Imagery

Activity Scheduling(Mastery and Pleasurable Tasks Scheduling)


General content of therapy (some samples only)

Cognitive‐Coping

Cognitive ‐ Restructuring

Graded Task Assignments


Process Techniques Commonly Used (some samples only)

Learned optimism

Constructive thinking

Idiosyncratic meaning

Questioning the evidence (Hypothesis testing)

Socratic questioningCollaborative

Problem Solving


Process Techniques Commonly Used (cont’d)

Guided discovery

Reattribution

Decatastrophising

Metaphors

Externalising

Downward ArrowTechnique


Suitability of Cross‐Cultural Population for Short‐Term CBT

Accessibility of automatic thoughts

Acceptance of personal responsibility

Compatiability with and acceptance of cognitive rationales

Alliance potential (as evident in early sessions)

Alliance potential (out of session)

Commitment to regular attendance and task completion)

Capacity to remain focused on key issues

Chronicity of problems

Client optimism/pessimism regarding therapy)

Awareness of & differentiation of emotions Safran, J D & Segal, Z V (1990)

“Suitability for Short‐Term Cognitive Therapy Rating Scale”


Currently no empirical studies demonstrating the effectiveness of this approach

•might be effective because of the “here and now”orientation;

•solution‐focused and action‐geared approach is more palatable to many Asian cultures.

•Adjustable and custom‐tailored approaches means more flexibility.

Long‐term outcome research studies particularlylacking

Suitability of Cross‐Cultural Population for Short‐Term CBT


REFERENCES

Hoffmann, S.G. (2006). The importance of culture in cognitive and behavioralpractice. Cognitive and Behavioral Practice, 13, pp243‐245.

Huang, DD., Charter, R.A. (1996). The Origin and Formation of Chinese Character: An introduction to confucianism and its influence on Chinese behavioral patterns . Cultural Diversity and Mental Health, 2 (1), pp 35‐42

Hwanga, W., Wood J.J., Lin, K., & Cheung, F (2006).Cognitive‐behavioural therapy with Chinese‐Americans: Research, theory and clinical practice. Cognitive andBehavioral Practice (vol 13 , 4, pp 293‐303).

References


cognitive behavioural therapy in a cross cultural … · suitability of cross‐cultural population...

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