Objective No randomized controlled trials (RCTs) for adults have tested the effectiveness of a well-specified psychotherapy compared with a culturally adapted version of the same treatment. This study evaluates the effectiveness of cognitive behavioral therapy (CBT) and culturally adapted CBT (CA-CBT) in treating depressed Chinese American adults. Methods This was a RCT that treated 50 Chinese Americans who met criteria for major depression and sought treatment at community mental health clinics. Participants were screened beginning September 2008, with the last assessment conducted in March 2011. Participants were randomly assigned to 12 sessions of CBT or CA-CBT. Stratified randomization was used for patients who were on and not on antidepressants when they first came to the clinic, and the study did not influence regular prescription practices. The primary outcomes were dropout rates and the Hamilton Depression Rating Scale measured at baseline, session 4, session 8, and session 12. Results Participants in CA-CBT evidenced a greater overall decrease in depressive symptoms than those in CBT, but depression rates remained similarly high at week 12. Differences in dropout rates approached, but did not meet statistical significance (7% CA-CBT and 26% CBT). Conclusions Chinese Americans entered this study with very severe depression. Participants in both CBT and CA-CBT evidenced 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.

No abstract

No abstract