The role of culture in treatment ERQ

The role of culture in treatment

It refers to how cultural beliefs, values, and practices influence the effectiveness and acceptability of psychological treatments.

Ward & Brown (2015) aim

To determine the effectiveness of a culturally adapted treatment for African Americans with MDD called the Oh Happy Day Class (OHDC), based on culturally specific group CBT.

Participants in Ward & Brown (2015)

Two pilot studies in a Midwestern U.S. suburb: Pilot I: 18 African American women (mean age = 75); Pilot II: 35 participants (18 women, 17 men; mean age = 51).

Procedure in Ward & Brown (2015)

Participants attended 2.5-hour weekly culturally adapted CBT group sessions for 12 weeks, focusing on depression coping skills, anger management, forgiveness, and constructive thinking.

Results of Ward & Brown (2015) Pilot I

73% who completed the course showed a significant reduction in depression symptoms.

Results of Ward & Brown (2015) Pilot II

66% completed the course, and both men and women showed a significant decrease in depression symptoms.

Satisfaction in Ward & Brown (2015)

Participants were satisfied with the course.

Attitudes toward mental health care in Ward & Brown (2015)

There was no significant change in attitudes toward seeking mental health care.

Conclusion of Ward & Brown (2015)

The OHDC program is effective in reducing depression in African Americans when cultural values and community-specific content are incorporated into therapy.

Strengths of Ward & Brown (2015)

Developed a culturally specific intervention that reflects African American identity and values; Used multiple time-point measurements (pre, mid, post, and follow-up), increasing reliability of results.

Limitations of Ward & Brown (2015)

Small, non-randomized sample limits generalizability; No control group, so improvements may be due to other factors like social support or placebo effects.

Hodge & Nadir (2008) aim

To investigate whether Western-style counseling practices are appropriate for Muslim clients, and which therapies align best with Islamic values.

Procedure in Hodge & Nadir (2008)

A review of previous research on four therapeutic approaches: psychoanalytic therapy, group therapy, strength-based therapy, and CBT.

Culturally competent services

Services that are tailored to meet the cultural and religious needs of clients.

Psychoanalytic therapy

A therapeutic approach that emphasizes individual introspection, which contrasts with the Muslim emphasis on community and religious identity.

Group therapy

A form of therapy that can be problematic in mixed-gender groups due to modesty and privacy concerns.

Strength-based therapy

A therapeutic approach that aligns with faith, family, and community values.

Cognitive Behavioral Therapy (CBT)

A therapeutic approach that can be congruent with Islamic values if adapted with faith-based self-talk.

Faith-based self-talk

Replacing standard affirmations with those that reflect religious beliefs, such as 'God supports me' instead of 'I am in control'.

Culturally adapted therapy

Therapy that is modified to align with the client's religious and cultural beliefs, enhancing treatment outcomes.

Practical applications of Hodge & Nadir (2008)

Offers strategies for schools, clinics, and hospitals in multicultural settings.

Flexibility of CBT

Demonstrates the adaptability of Cognitive Behavioral Therapy across diverse belief systems.

Generalized conclusions

The conclusions of Hodge & Nadir (2008) may not apply to all Muslims due to individual differences and variations in Islamic sects.

Secondary data limitations

The reliance on secondary data in Hodge & Nadir (2008) limits control over the quality of original studies and reduces reliability.

Cultural influence on treatment effectiveness

Culture shapes how people express symptoms, seek help, and respond to treatment, making culturally aligned therapies more effective.

Individualistic cultures

Cultures that value independence, such as the USA and UK, making individual CBT a suitable fit.

Collectivist cultures

Cultures that prioritize family, community, and religion, necessitating treatments that include group identity or spiritual frameworks.

Cultural attitudes toward mental illness

Some cultures may view mental illness as a family issue or moral weakness, leading to stigma.

Western cultural attitudes

Western cultures may encourage openness about mental illness, unlike some collectivist cultures that discourage disclosure.

Symptom presentation across cultures

In some cultures, depression may be expressed through somatic symptoms like fatigue or body pain rather than emotional symptoms.

Culturally adapted treatments

Treatments like OHDC and faith-informed CBT that respect clients' worldviews and show promising results.

One-size-fits-all model

The idea that treatments must go beyond a single Western model to be effective across different cultures.

Hodge & Nadir (2008) conclusion

Therapy should be culturally adapted to enhance effectiveness and respect for Muslim clients.

Strengths of Hodge & Nadir (2008)

Demonstrates the flexibility of CBT and offers practical applications for multicultural settings.

Limitations of Hodge & Nadir (2008)

Generalizations may not apply to all Muslims and reliance on secondary data limits reliability.