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Cited by 11Psychotherapy Techniques and ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional Development

A Comparison of Interactions Among Children, Parents, and Therapists in Cognitive Behavior Therapy for Anxiety Disorders in Australia and Japan

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Ishikawa, Shin-ichi, Romano, Mia, Hudson, Jennifer L.·2022·Behavior Therapy
DOI 10.1016/j.beth.2021.05.008
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Abstract

Despite growing attention to the efficacy of culturally adapted cognitive-behavioral treatment (CBT) programs for children and adolescents, there is still little empirical and practical information available to therapists who adapt original treatment protocols to suit clients of a specific culture. The current study aimed to compare therapeutic interactions across CBT treatment delivered with two different cultural groups. We developed an observational coding system to examine behaviors exhibited by child, parent, and therapist during CBT sessions conducted in Australia and Japan for children with anxiety disorders. Our results demonstrated significant differences between the two countries with respect to the treatment readiness of children, the proportion of talking during the sessions by parents and children, therapists' laughter, length of silence during the first session, and parent indices of accommodation. In terms of transitions over time (i.e., first to last CBT session), parents in both countries tended to talk more during the last CBT session, whereas only Australian therapists talked less over time. The proportion of silence decreased over time during the Japanese sessions, and the amount of interruptions by parents increased over time for Australian sessions. Finally, our exploratory analyses demonstrated that a number of behavioral observations were correlated with anxiety treatment outcome at posttreatment. This study suggests that interactions between a child, parent, and therapist during CBT sessions may be affected by the culture in which the CBT session occurs, which could have implications for culturally adapted CBT programs.

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  • In the broader psychosocial intervention literature, CBT has shown robust results with cultural adaptations, including linguistic modifications.

    “In the broader psychosocial intervention literature, interventions like Cognitive Behavioral Therapy (CBT) have shown robust results with cultural adaptations, including linguistic modifications [10].”

    From Centering Diverse Communities within Mindful Parenting Interventions in the U.S.: A Narrative Literature Review (2024) · cites this paper as [10]

    The paper’s background discussion (page unavailable) reports beneficial outcomes from culturally adapted treatments, and its discussion of a Japanese CBT trial reports better posttreatment outcomes than a wait-list control. It does not identify linguistic modifications as part of those adaptations or link them to the reported outcomes, so that detail is unsupported. (LLM, conf=0.84)

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  • The literature for other manualized treatment modalities asserts that cultural adaptations-such as linguistic or conceptual alterations-enhance the adherence and effectiveness of an intervention.

    “the literature for other manualized treatment modalities asserts that cultural adaptions—such as linguistic or conceptual alterations—enhance the adherence and effectiveness of an intervention [10]”

    From Centering Diverse Communities within Mindful Parenting Interventions in the U.S.: A Narrative Literature Review (2024) · cites this paper as [10]

    The paper’s Abstract reports that previous meta-analyses found beneficial therapeutic outcomes for culturally adapted treatments and says adaptation aims to increase client engagement. It does not establish that linguistic or conceptual alterations enhance treatment adherence, or that those specific alterations improve effectiveness. (LLM, conf=0.84)

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Cites

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Research works printed but not linked: 8

  1. Hwang, W. C. (2016). Culturally adapting psychotherapy for Asian heritage populations: An evidence-based approach. Elsevier Academic Press.
  2. Ishikawa, S., & Sakano, Y. (2003). Cognitive error and trait anxiety in children: Development of a Children's Cognitive Error Scale. Japanese Journal of Behavior Therapy, 29, 145-157.
  3. Ishikawa, S., & Sakano, Y. (2005). Investigation on the relationship between self-statement and anxiety symptoms in childhood. Japanese Journal of Behavior Therapy, 31, 45-57.
  4. Leong, F. T., Lee, S. H., & Chang, D. (2008). Counseling Asian Americans. In P. B. Pederson, J. G. Draguns, W. J., Lonner, & J. E. Trimble (Eds.), Counseling across cultures (6th ed., pp. 113-128). Sage.
  5. O ¨st, L. -G., & Ollendick, T. H. (1999). Manual for the One Session Treatment (OST) of specific phobia in children and adolescents. (Unpublished manual). · DOI · Paper page
  6. Pasalich, D. S., & Dadds, M. R. (2009). Family observation schedule (6th ed.). Child Behaviour Research Clinic, School of Psychology, University of New South Wales.
  7. Silverman, W. K., & Albano, A. M. (1996). Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent versions. Oxford University Press.
  8. Tanaka-Matsumi, J. (2011). Culture and psychotherapy: Searching for empirically supported relationship. In K. D. Keith (Ed.), Cross-cultural psychology: Contemporary theme and perspective (pp. 274-292). Wiley-Blackwell. RECEIVED: November 3, 2020 ACCEPTED: May 27, 2021 AVAILABLE ONLINE: 5 JUNE 2021

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Authors
Ishikawa, S.-I., Romano, M., & Hudson, J. L.
Affiliations
  • Doshisha University (JP)
  • Macquarie University (AU)
  • Black Dog Institute (AU)
Corresponding author
Ishikawa, Shin-ichi
ORCID
Venue
Behavior Therapy
Publisher
Elsevier BV
Published
2022-01
Volume
53
Issue
1
Pages
34-48
ISSN
0005-7894 (ISSN-L)
DOI
10.1016/j.beth.2021.05.008
OpenAlex
W3167822123
Cited by
11
References
34
Citations by year
2026: 1 · 2025: 3 · 2024: 2 · 2023: 5
FWCI
1.19
Type
journal article
Language
en
Open access
Licence
Locations
  • Behavior Therapy (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
Funders
Japan Society for the Promotion of Science (16KK0090)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
cognitive behavioral therapy, childhood anxiety disorders, culturally tailored interventions, cross-cultural comparison, Australia, Japan, treatment readiness, treatment outcomes
MeSH terms
Adolescent, Anxiety Disorders, Australia, Child, Humans, Japan, Parents, Cognitive Behavioral Therapy, Treatment Outcome

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