Effective psychotherapy in a racially and culturally diverse society

Bhui, Kamaldeep; Morgan, Neil

doi:10.1192/apt.bp.106.002295

Cited by 23 publications

(10 citation statements)

References 14 publications

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“…CBT has been devised and consistently developed for OCD treatment in Western culture since the 1960s and 1970s (Taylor ; Foa ) and was introduced to China. The response rate in this study is similar to reported studies in Western populations, suggesting that CBT is applicable in different cultures, although the efficacy of psychotherapy is affected by cultural factors (Bhui and Morgan ). It is known that symptoms of OCD have varied little over time (pathological scrupulosity, for example, has long been documented) or place (similar symptoms are seen across many cultures; Ames et al.…”

Section: Discussionsupporting

confidence: 87%

A promising randomized trial of a new therapy for obsessive–compulsive disorder

Wen

Ma³

et al. 2012

Brain and Behavior

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Pharmacotherapy and cognitive–behavioral therapy (CBT) are currently the most effective interventions for treating obsessive–compulsive disorder (OCD). These treatments, however, are time consuming and in some cases the patients do not show significant improvement. In all, 30%–60% of OCD patients do not respond adequately to pharmacotherapy and 20%–40% of OCD patients who complete CBT do not improve significantly, suggesting a more efficacious approach is needed. The objectives of this study are to demonstrate an efficacious pharmacotherapy plus psychotherapy, named cognitive–coping therapy (CCT), for OCD and to investigate the efficacy of this approach in a larger sample size. Therefore, a total of 108 patients with OCD were randomly allocated into three groups: pharmacotherapy (N = 38), pharmacotherapy plus CBT (PCBT, N = 34), and pharmacotherapy plus CCT (PCCT, N = 36). The severity of symptoms and the patients' functioning were assessed pretreatment and after 7, 14, 21 days, and 1-, 3-, 6-, and 12-month treatment using the Yale-Brown Obsessive Compulsive Scale and Global Assessment of Functioning (GAF). Compared with the pharmacotherapy and PCBT groups, the severity of OCD symptoms was significantly reduced (P < 0.001), the rates of response (100%) and remission (85.0%) were significantly higher (P < 0.001), and relapse rate was lower (P = 0.017) in PCCT group during the 1-year follow-up. In addition, the GAF score was significantly higher in the PCCT group than in the other two groups (P < 0.001). Our preliminary data suggest that PCCT is a more efficacious psychotherapy for OCD patients than pharmacotherapy or PCBT.

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Section: Discussionsupporting

confidence: 87%

A promising randomized trial of a new therapy for obsessive–compulsive disorder

Wen

Ma³

et al. 2012

Brain and Behavior

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“…In addition, older female moderators of similar ethnic background for psychoeducation were deemed most appropriate because this would cater for cultural and gender differences, and enhance cultural identity between the postpartum women and the moderators. There are other similar findings in other studies [11,27]. Cultural appropriateness of a programme caters for the diverse dimensions of a culture including literacy.…”

Section: Discussionsupporting

confidence: 87%

An exploratory study on the feasibility and appropriateness of family psychoeducation for postpartum women with psychosis in Uganda

et al. 2013

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BackgroundWe explored how family psychoeducation could be made culturally sensitive for postpartum mothers with psychotic illness in a Ugandan setting.MethodsA qualitative multi-method approach using an already existing family psychoeducation Tool Kit was adapted to incorporate lay perceptions related to psychotic illness in the postpartum period in this Ugandan setting. The participants consisted of postpartum women with psychotic illness, caregivers/family members, psychiatric nurses and psychologists. A modified version of a family psychoeducation programme for postpartum women with psychosis was formulated and pilot-tested.ResultsModifications in the standard family psychoeducation programme were both in the process and content of family psychoeducation. Under process, effective communication, cultural background, appropriate dress, involving only one family member, low literacy, and flexibility in timekeeping were raised. The theme of content yielded the incorporation of lay perceptions of mental illness, family planning, income generating, and an emphasis of premorbid and morbid personalities of the patients.ConclusionThe basic principles and assumptions underlying psychoeducation remained the same. Changes made in the process and content of family psychoeducation reflected the social, cultural and gender reality of the population.

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“…The literature to date has commented on the potentially problematic nature of this endeavour (e.g., Baxter & Cheng, 1996;Bhui & Morgan, 2007;Miller et al, 2005;Tribe & Thompson, 2009). The current case study demonstrates the potential of psychodynamic psychotherapy within an interpreter-assisted context.…”

Section: Discussionmentioning

confidence: 99%

“…Baxter and Cheng (1996) question the patient's ability to "express transference through an interpreter" (p.154) and the clinician's ability to discern transference in translated material. The question of whether interpreter assisted psychotherapy can achieve the level of intimacy necessary for psychodynamic work is also problematic (Bhui & Morgan, 2007).…”

mentioning

confidence: 99%

Lost in translation, found in translation: A case study of working psychodynamically in an interpreter-assisted setting

Schweitzer

Rosbrook

Kaiplinger

2013

Psychodynamic Practice

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Effective use of psychotherapeutic treatment in interpreter-assisted settings is well established; however, there has been little discussion of the use of psychodynamicallyinformed treatments in such settings. The literature suggests that therapy facilitated by interpreters is not conducive to psychodynamic approaches due to the presence of a third person, the perceived lack of intimacy, and the difficulties of working with translated material. However, transference, countertransference and other unconscious communications and responses necessarily occur in every therapeutic setting, including triadic therapy using interpreters. This paper describes a short-term (12 session) psychodynamically-oriented intervention with a 52-year old Cantonese-speaking man suffering from depression. A female, Chinese-born interpreter assisted in every session. The integral role of supervision in supporting a containing relationship between the therapist and the patient and the difficult emotional responses experienced by the interpreter is highlighted. The paper attempts to trace some of the unconscious communications that occurred during the therapy and demonstrates the feasibility of working psychodynamically in an interpreter-assisted setting.Keywords: Psychodynamic, Interpreters, Cross-cultural, Transference, Countertransference, Chinese Working Psychodynamically in an Interpreter-Assisted SettingAustralian society has become increasingly multicultural which has necessitated the increasing use of interpreters in counselling and psychotherapy with clients from non English speaking backgrounds. Despite recognition of the potential for effective psychotherapy using interpreters, there is limited research on the topic. Difficulties associated with using interpreters in therapy are exacerbated in psychodynamic settings. Fundamental to interpreterassisted therapy are differences in language and culture of client and therapist. The idea that a clinician and patient, speaking different languages, can function as an exclusive dyad, assisted on a purely practical level by an interpreter who is like a "black box" in sessions has been called into question (Westermeyer, 1990;Miller et al., 2005). The addition of a third person (the interpreter) changes the therapeutic configuration from dyadic to triadic. From a dynamic perspective each of these relationships are coloured by each person's unconscious which they bring to the treatment setting.Transference and countertransference in interpreter-assisted therapy is highly complex (Westermeyer, 1990). The resulting dynamics of the therapeutic relationship are seen as

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Effective psychotherapy in a racially and culturally diverse society

Cited by 23 publications

References 14 publications

A promising randomized trial of a new therapy for obsessive–compulsive disorder

A promising randomized trial of a new therapy for obsessive–compulsive disorder

An exploratory study on the feasibility and appropriateness of family psychoeducation for postpartum women with psychosis in Uganda

Lost in translation, found in translation: A case study of working psychodynamically in an interpreter-assisted setting

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