cognitive behavioural therapy in a cross cultural … · suitability of cross‐cultural population...
TRANSCRIPT
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?
Copyright ©2008 J.Sundararaman
Copyright ©2008 J.Sundararaman
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
Copyright ©2008 J.Sundararaman
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
Copyright ©2008 J.Sundararaman
Increase Self‐Awareness
Increase Coping Strategies
Decrease Emotional Distress
Decrease Maladaptive Behaviours
Develop Habits of Constructive Thinking
CBT Goals for the Client
Copyright ©2008 J.Sundararaman
Therapist Client
Copyright ©2008 J.Sundararaman
Copyright ©2008 J.Sundararaman
General content of therapy (some samples only)
Psycho‐education
Self‐Monitoring
Relaxation Training
Imagery
Activity Scheduling(Mastery and Pleasurable Tasks Scheduling)
Copyright ©2008 J.Sundararaman
General content of therapy (some samples only)
Cognitive‐Coping
Cognitive ‐ Restructuring
Graded Task Assignments
Copyright ©2008 J.Sundararaman
Process Techniques Commonly Used (some samples only)
Learned optimism
Constructive thinking
Idiosyncratic meaning
Questioning the evidence (Hypothesis testing)
Socratic questioningCollaborative
Problem Solving
Copyright ©2008 J.Sundararaman
Process Techniques Commonly Used (cont’d)
Guided discovery
Reattribution
Decatastrophising
Metaphors
Externalising
Downward ArrowTechnique
Copyright ©2008 J.Sundararaman
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”
Copyright ©2008 J.Sundararaman
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
Copyright ©2008 J.Sundararaman
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
Copyright ©2008 J.Sundararaman
Copyright ©2008 J.Sundararaman