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Cited by 86Psychotherapy Techniques and ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and Access

Culturally Adapted Cognitive-Behavioral Therapy for Chinese Americans With Depression: A Randomized Controlled Trial

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Hwang, Wei-Chin, Myers, Hector F., Chiu, Eddie, Mak, Elsie, Butner, Jonathan E., Fujimoto, Ken, Wood, Jeffrey J., Miranda, Jeanne·2015·Psychiatric Services
DOI 10.1176/appi.ps.201400358PMC PMC4591116
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Abstract

OBJECTIVE: No randomized controlled trials (RCTs) for adults have compared the effectiveness of a well-specified psychotherapy and a culturally adapted version of the same treatment. This study evaluated the effectiveness of cognitive-behavioral therapy (CBT) and culturally adapted CBT (CA-CBT) in treating depressed Chinese-American adults. METHODS: This RCT treated 50 Chinese Americans who met criteria for major depression and sought treatment at community mental health clinics. Screening of participants began in September 2008, and the last assessment was conducted in March 2011. Participants were stratified by whether they were already taking antidepressants when they first came to the clinic and randomly assigned to 12 sessions of CBT or CA-CBT. The study did not influence regular prescription practices. The primary outcomes were dropout rates and Hamilton Depression Rating Scale scores at baseline, session 4, session 8, and session 12. RESULTS: Participants in CA-CBT demonstrated a greater overall decrease in depressive symptoms compared with participants in CBT, but the groups had similarly high depression rates at week 12. Differences in dropout rates for the two groups approached, but did not meet, statistical significance (7%, CA-CBT; 26%, CBT). CONCLUSIONS: Chinese Americans entered this study with very severe depression. Participants in both CBT and CA-CBT demonstrated significant decreases in depressive symptoms, but the majority did not reach remission. Results suggest that these short-term treatments were not sufficient to address such severe depression and that more intensive and longer treatments may be needed. Results also indicate that cultural adaptations may confer additional treatment benefits.

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  • Among interventions specifically tailored to Asian Americans, there are only a handful of recent culturally adapted interventions.

    “Among the interventions specifically tailored to AAs, there are only a handful of recent “culturally adapted interventions.””

    From Guest Editors' Introduction to the Special Section: Cultural Adaptation of Mental Health Interventions for Americans of East Asian Descent (2019) · cites this paper as Hwang et al., 2015

    The Objective (page not provided) says Asian Americans have rarely been included in rigorous psychotherapy trials and describes this study’s culturally adapted treatment for Chinese Americans. That supports the general point that research is limited, but it does not establish that only a handful of recent culturally adapted interventions tailored to Asian Americans exist; its scarcity claim concerns rigorous trials. (LLM, conf=0.82)

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  • Specific adaptations to Cognitive Behavioral Therapy and Problem-Solving Therapy have been made to make treatment more effective for Asian Americans.

    “These include specific adaptations to Cognitive Behavioral Therapy (Hinton, Safren, Pollack, & Tran, 2006; Hwang et al., 2015) and Problem-Solving Therapy (Chu, Huynh, & Areán, 2012) in order for the treatment to be more effective in treating AAs.”

    From Guest Editors' Introduction to the Special Section: Cultural Adaptation of Mental Health Interventions for Americans of East Asian Descent (2019) · cites this paper as Hwang et al., 2015

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Research works printed but not linked: 2

  1. [8]Smith TB Domenech Rodríguez MM Bernal G Culture J Clin Psycholol 2011 67 166 175 21105069
  2. [42]Williams JB A structured interview guide for the Hamilton Depression Rating Scale Arch Gen Psychiatry 1988 45 8 742 747 3395203

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Authors
Hwang, W.-C., Myers, H. F., Chiu, E., Mak, E., Butner, J. E., Fujimoto, K., Wood, J. J., & Miranda, J.
Affiliations
  • Claremont McKenna College (US)
  • Dr. Hwang is with the Department of Psychology, Claremont McKenna College, Claremont, California (e-mail: ). Dr. Myers is with the Department of Psychology, Dr. Wood is with the Department of Education, and Dr. Miranda is with the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Dr. Chiu is with the Department of Psychology, Alliant University, San Francisco. Dr. Mak is with the Department of Psychology, Palo Alto University, Palo Alto, California. Dr. Butner is...
ORCID
Venue
Psychiatric Services
Publisher
American Psychiatric Association Publishing
Published
2015-10-01
Volume
66
Issue
10
Pages
1035-1042
ISSN
  • 0022-1597 (ISSN-L)
  • 1075-2730
  • 1557-9700
DOI
10.1176/appi.ps.201400358
PMC
PMC4591116
OpenAlex
W2180711606
Cited by
86
References
54
Citations by year
2026: 7 · 2025: 10 · 2024: 5 · 2023: 15 · 2022: 6 · 2021: 6 · 2020: 13 · 2019: 8 · 2018: 5 · 2017: 3 · 2016: 6 · 2015: 2
FWCI
6.62
Type
journal article
Language
en
Open access
Locations
  • Psychiatric Services (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
National Institute of Mental Health (R34MH073545, 1R34MH73545-01A2)
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 › Social Psychology › Mental Health Treatment and Access
Keywords
cognitive behavioral therapy, major depressive disorder, Chinese Americans, cultural adaptation of psychotherapy, treatment discontinuation, depressive symptom reduction, community mental health centers, severe depression
MeSH terms
Adult, Antidepressive Agents, Asian, Cognition, Major Depressive Disorder, Depressive Disorder, Major, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, United States, Cognitive Behavioral Therapy, Culturally Competent Care

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