dbt cultural appropriation

The authors describe the process of cultural adaptation in some detail, e.g. 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. Self-practice, self-reflection (Chigwedere et al., Reference Chigwedere, Thwaites, Fitzmaurice and Donohoe2019) and the critical incident analysis model can be useful tools for these therapists. This paper examines the Greek cultural, linguistic schema of Politeness Plural in the application of a Schema Therapy mode model. No Comments have been published for this article. As the review included only a small number of case studies, it will be too early to draw any conclusions. Hostname: page-component-75b8448494-jf2r5 distress tolerance. The authors examined the fidelity and flexibility of treatment elements. 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). Pratt, Daniel Flaskerud and Strehlow (Reference Flaskerud and Strehlow2008) suggest that apparent apathy and neglect of this highly marginalized, traumatized and disadvantaged population might be due to our belief in individual responsibility, free will and self-determination. These authors have touched on a highly sensitive issue in a very skilful, diligent and empathic manner. They discuss two themes (therapist effects and process) in detail, as they believe these to be particularly relevant to the clinical application of the therapy in this context. At first glance, it appears that this Nitty gritty. Finally, two papers describe the importance of self-reflection, self-practice and supervision (Brooks, Reference Brooks2019) and therapist self-disclosure (Phiri et al., Reference Phiri, Rathod, Gobbi, Carr and Kingdon2019). This paper highlights a gap and provides the way forward in working with a highly stigmatized group. 2021. 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. Some examples of cultural sensitivity included: need to be aware of service users culture, language barriers and translations, level of acculturation, socio-cultural constructs, therapeutic relationship and style of therapy, which are in line with the existing literature (Hays and Iwamasa, Reference Hays and Iwamasa2006; Hwang et al., Reference Hwang, Myers, Chiu, Mak, Butner, Fujimoto and Miranda2015; Naeem et al., Reference Naeem, Phiri, Rathod and Ayub2019; Organista and Muoz, Reference Organista and Muoz1996; Ward and Brown, Reference Ward and Brown2015). Byford, Sarah Orthodox Jews and Muslims (Kada, Reference Kada2019; Mir et al., Reference Mir, Ghani, Meer and Hussain2019). 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. All these patients had a strict religious upbringing and had dysfunctional beliefs underpinned by their cultural and religious values. Susana Castaos-Cervantes (Castaos-Cervantes, Reference Castaos-Cervantes2019) describes the preliminary efficacy of a brief cognitive behavioural group therapy group intervention tailored to Mexican homeless girls. WebDBT is an intervention that has demonstrated efficacy for reducing suicidality (Swales et al., 2000), which may be effective among Native American clients. The authors also report feasibility, acceptability and preliminary effectiveness of the intervention. I start with a systematic review of CBT for social anxiety across cultures. To fully understand its consequences, though, we need to make sure we have a working definition of culture itself. and 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. Therapists focused on cultural factors during assessment and engagement, shared learning, communication, coping skills and endings. Therapists often do not discuss service users experiences of racism. This will require establishing trust and partnership with the community. As homosexuality is considered a sin in Islam, it might be worth exploring the link between the concept of sin and associated shame in this context. Authors suggest that there can be significant benefits for services to provide IAPT training to people already providing culturally specific services. Neufeld, Carmem Beatriz Read Their experience of racism, perceived biases and discrimination mean that TSD can play a vital role in building trust and improving engagement (Beck and Naz, Reference Beck and Naz2019). Singh, Anneesa D. Farrelly, Maria Hudson, Jennifer L. There was no association between time devoted to coping strategies and traumatic stress scores (Bober and Regehr, Reference Bober and Regehr2006). The next step should be a large scale evaluation of the manualized form of this intervention. The term cultural appropriation is thought to The participants reported that low-intensity CBT (LiCBT) was useful, but only when cultural adaptations were made. Here, I briefly summarize and discuss the papers in this special issue. Kenneth Fung has reported high levels of acceptance of ACT while working with the Cambodian community in Toronto (Fung, Reference Fung2015). Gender and sexual minorities (GSM) are over-represented in the migrating population. The t-v (tu-vos) distinctions are common around the globe and expressed in a variety of forms. 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). interpersonal effectiveness. Their distress is compounded by views of their family at home and members of their community in their host country. The authors provide case examples. It is heartening to see the breadth and width of topics covered in this special issue. 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. Clark, Kirsty A. Finally, the authors list available resources in training in military culture for therapists. A transdiagnostic community-based mental health treatment for comorbid disorders: development and outcomes of a randomized controlled trial among Burmese refugees in Thailand, A randomized controlled trial of a transdiagnostic cognitive-behavioral intervention for Afro-descendants survivors of systemic violence in Colombia, The lack of cancer surveillance data on sexual minorities and strategies for change, Differences in self-disclosure patterns among Americans versus Chinese: a comparative study, Cultural adaptation of dialectical behavior therapy for a Chinese international student with eating disorder and depression, Self-practice/self-reflection as an alternative to personal training-therapy in cognitive behavioural therapy training: a qualitative analysis, Religious and ethnic group influences on beliefs about mental illness: a qualitative interview study, The stress response systems: universality and adaptive individual differences, Incidence of schizophrenia and other psychoses in ethnic minority groups: results from the MRC AESOP Study, Matching client and therapist ethnicity, language, and gender: a review of research, Using mindfulness- and acceptance-based treatments with clients from nondominant cultural and/or marginalized backgrounds: clinical considerations, meta-analysis findings, and introduction to the special series. Same-sex relationships were generally tolerated in pre-modern Islamic societies. The term cultural appropriation, is by far a familiar one. This paper, therefore, is a welcome addition to the existing literature in the area. This special edition, therefore, is a welcome addition to a fast-growing area in CBT research and practice: the cultural adaptation of CBT. Historically, deciding exactly what culture is hasnt been easy. There is at least some evidence that people from some non-Western culture are less likely to self disclose (Chen, Reference Chen1995; Yoo, Reference Yoo2012). They highlight the need for commitment and investment, by all stakeholders, such as therapists, supervisors, clinical leads, service managers, Clinical Commissioning Groups (CCGs) and NHS England. One paper describes a practice protocol for dissociative symptoms (Chessell et al., Reference Chessell, Brady, Akbar, Stevens and Young2019), another describes the use of CBT with asylum seekers (King and Said, Reference King and Said2019), and the third paper describes CBT with Mexican homeless girls (Castaos-Cervantes, Reference Castaos-Cervantes2019). While the authors mention elements of cultural adaptation of the manual, no systematic attempts were made to adapt the manual culturally. The authors argue that holding on to the Politeness Plural linguistic schema may reinforce emotional distancing and might compromise schema healing. 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. However, much of the public remains confused about what the Ghazala Mir and co-workers have culturally adapted behavioural activation (BA) for Muslim service users in England. Kada suggests adaptations both at the individual therapist level (to make therapy acceptable) and at the service level (to improve access and engagement). 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). They describe their efforts in adapting therapy for their service users on an individual level, barriers to access to IAPT services and lack of training for therapists from majority ethnic backgrounds. This declaration asserts that cultural pluralism pre-supposes respect for human rights. In some non-Western cultures, these expressions are accompanied by a set of gestures, for example, lowering of eyes or head (Cultural Atlas, 2019). 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. 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. Sclare, Irene Developmental considerations included focusing on concrete concepts, using simplified language, vocabulary, and age-appropriate activities. The findings of Stone and Warren, in particular people in low- and middle-income countries not being aware of the existence of modern psychotherapies and professionals reliance on a medical model, are in line with published literature (Naeem et al., Reference Naeem, Gobbi, Ayub and Kingdon2010). Three papers (d) focus on refugees, asylum seekers and the homeless. This issue can be addressed in future research. While lower prevalence rates of SAD are reported from some non-Western cultures (Hofmann et al., Reference Hofmann, Asnaani and Hinton2010), these might be due to individuals seeking help from practitioners of traditional, complementary and alternative medicine (Gureje et al., Reference Gureje, Nortje, Makanjuola, Oladeji, Seedat and Jenkins2015). This paper reports on the process of culturally adapted family intervention from a therapists perspective. They suggest more empirical research in this field. 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). Shearer, James However, findings from this review certainly draw attention to the need for more research in this area. The protocol was developed in a specialist NHS (National Health Service, England) programme for migrants with PTSD. The authors emphasize some of the salient features of military culture: the organizational structure of the military and its branches, a timeline of major wars and operations, the ranking hierarchy, and its language that should be considered in adapting therapy for this group. 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. for this article. hasContentIssue false, British Association for Behavioural and Cognitive Psychotherapies 2019. While literature reports perceived barriers to accessing mental health services among BME communities (Memon et al., Reference Memon, Taylor, Mohebati, Sundin, Cooper, Scanlon and Visser2016), not many models of improving access to psychological services for the BME group exist. These authors describe an evidence-based framework that has evolved over a decade. This paper describes the use of CBT with four patients with vaginismus in Tunisia. However, it is yet to be determined how sustainable these therapies are in the long term. This paper describes one of the themes from that study in greater detail, i.e. Scotton, Isabela Lamante This brief manualized intervention can be delivered in four sessions and might be applicable across cultures. Chan, Ngan Yin There is a need to adapt CBT for this group using a systematic approach. 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). Bertie, Lizl-Antoinette Rebessi, Isabela Pizzarro Lisk, Stephen 02 September 2019. Most importantly, this definition does not limit culture to race, religion or nationality, thus recognizing cultural aspects of groups based on gender, gender preferences, age and disabilities. 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. 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). 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. The creation of a new workforce requiring additional funding might pose a barrier in uptake into the systems with low resources, or might not be necessary. One paper discusses the application of dialectical behaviour therapy (DBT) with LGBTQ service users (Skerven et al., Reference Skerven, Whicker and LeMaire2019), another describes a case series of vaginismus therapy in Tunisia (Zgueb et al., Reference Zgueb, Ouali, Achour, Jomli and Nacef2019), while the third paper reports use of behaviour therapy when working with gender and sexual minorities in the context of Islamic culture (Langroudi and Skinta, Reference Langroudi and Skinta2019). The authors provide their perspectives on the terms race, culture and ethnicity and share their understanding of these terms for CBT therapists. The authors have expanded on their work over a decade in developing a framework for cultural adaptation of CBT that can be replicated (Naeem et al., Reference Naeem, Phiri, Munshi, Rathod, Ayub, Gobbi and Kingdon2015a; Naeem et al., Reference Naeem, Rathod, Khan and Ayub2016a,b; Naeem et al., Reference Naeem, Phiri, Rathod and Ayub2019; Rathod et al., Reference Rathod, Kingdon, Phiri and Gobbi2010). 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). This article emphasizes the role of mental health services and accreditation bodies. I will now briefly consider each of the papers in this special issue of the Cognitive Behaviour Therapist, providing a short summary of each paper, followed by a discussion, including suggestions on further enhancing our understanding of cultural issue related to CBT and on further promoting CBT across cultures and the subcultures. I agree that community centres might be a suitable alternative to deal with stigma. Stigma and discrimination based on sexual orientation or gender identity have a severe impact on the mental health of LGBTQ+ people (Meyer, Reference Meyer2003). In particular, it was possible to engage service users in family intervention for psychosis with and without biological family members. How dysfunctional are the dysfunctional attitudes in another culture? This paper offers a wealth of information and insights, and highlights the need for incorporating religious and spiritual factors in formulation and treatment (Josephson, Reference Josephson2004; Miller, Reference Miller2004). Adaptation of CBT for service users from a variety of cultures and sub-cultures can be seen as an extension of this process. This work encourages us to discuss the clients religious and cultural beliefs and to engage the client as experts not only in their problems but also in their culture and religion. This case report describes the application of CBT in dealing with family accommodation (defined as how relatives, in particular parents, may assist in compulsive rituals, provide reassurance or modify their routines to alleviate or avoid the distress experienced by the obsessive-compulsive child). Andrew Beck starts by presenting evidence that experience of racism can be a cumulative risk factor for developing mental health problems. In the 21st century, cultural appropriationlike globalizationisnt just inevitable; its potentially positive. Haddock, Gillian Other authors have suggested the idea that neutral places in the community might improve access to services and engagement with the BME communities (Beck and Naz, Reference Beck and Naz2019; Kada, Reference Kada2019). 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. 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). This article describes a clinical protocol for supporting those presenting with PTSD and severe dissociative symptoms, particularly dissociative flashbacks, based on a cross-culturally applicable model. (Reference Hakim, Thompson and Coleman-Oluwabusola2019) explored the experience of four IAPT low-intensity Psychological Wellbeing Practitioners (PWP) who had previously worked as BME Community Mental Health Workers (CMHW). The authors describe culturally adapted techniques they used to make therapy compatible with the local cultural context. Not all the LAMICs are the same, with wide variations in terms of the level of education, resources and availability of trained therapists. Even when the participants background is reported, a broader term such as White, Asian or Black is used, ignoring variations among these groups. Li, Shirley Xin Therapy was delivered by lay counsellors in Iraq and Thailand to treat trauma victims. However, the full potential of culturally adapted interventions will not be realized until and unless access to CBT is improved. Contributors to this special issue of the Cognitive Behaviour Therapist have tackled the issues around the cultural adaptation of CBT from various perspectives, using a variety of methods, and have addressed topics ranging from cultural adaptation to improving access to CBT. McConocha, Erin Other notable examples of adaptation include: engagement (games, demonstrations, metaphors), use of interpreters to address the language needs of the group, and considering physical health needs at the start of the intervention. They rightly point out that adaptation work does not suggest changes in mental health care systems. As the UASCs have typically experienced multiple losses, traumatic experiences, significant disruption and psychosocial stressors, a trauma focus approach was used. Most importantly, this definition does not limit culture to race, religion or Raphael Kada (Kada, Reference Kada2019) describes his experience of providing CBT for the Jewish community. 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 Case studies in this review were reported from the USA and Japan. Finally, this special issue publishes seven articles (f) on issues related to service delivery, practice, training and supervision when working with a diverse population. Stone and Warren previously reported the development and implementation of a CBT training course for clinicians working in Tanzania (Stone and Warren, Reference Stone and Warren2011). Finally, cultural considerations should be an essential part of the CBT courses and training of new CBT therapists. 12. Evidence from fully powered trials will help towards implementation not just in England but in Muslim countries too. Both the cultural adaptation of CBT that focuses on differences across cultures and a universalist approach focusing on similarities across cultures merit further investigation. There is also evidence to suggest that using online platforms for delivering CBT might address cultural barriers (Alavi et al., Reference Alavi, Hirji, Sutton and Naeem2016). Culture, religion and spirituality influence the belief systems of people, including beliefs about illness, its causes and treatment (Cinnirella and Loewenthal, Reference Cinnirella and Loewenthal1999; Ismail et al., Reference Ismail, Wright, Rhodes and Small2005; Razali et al., Reference Razali, Khan and Hasanah1996).

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