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Randomized Controlled Trial
. 2011 Jan;17(1):11-22.
doi: 10.1037/a0022534.

Culturally adapted versus standard exposure treatment for phobic Asian Americans: Treatment efficacy, moderators, and predictors

David Pan  1 , Stanley J Huey Jr, Dominica Hernandez
Affiliations
Randomized Controlled Trial

Culturally adapted versus standard exposure treatment for phobic Asian Americans: Treatment efficacy, moderators, and predictors

David Pan et al. Cultur Divers Ethnic Minor Psychol. 2011 Jan.

Abstract

This study is a 6-month follow-up of a randomized pilot evaluation of standard one-session treatment (OST-S) versus culturally adapted OST (OST-CA) with phobic Asian Americans. OST-CA included seven cultural adaptations drawn from prior research with East Asians and Asian Americans. Results from 1-week and 6-month follow-up show that both OST-S and OST-CA were effective at reducing phobic symptoms compared with self-help control. Moreover, OST-CA was superior to OST-S for several outcomes. For catastrophic thinking and general fear, moderator analyses indicated that low-acculturation Asian Americans benefitted more from OST-CA than OST-S, whereas both treatments were equally effective for high-acculturation participants. Although cultural process factors (e.g., facilitating emotional control, exploiting the vertical therapist-client relationship) and working alliance were predictive of positive outcomes, they did not mediate treatment effects. This study offers a potential model for evaluating cultural adaptation effects, as well as the mechanisms that account for such effects.

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Figures

Figure 1
Figure 1
Flowchart of study’s recruitment, allocation, follow-up, and analysis.
Figure 2
Figure 2
Steps completed on Behavioral Approach Test (BAT) (left panel), final Subjective Units of Distress (SUDs) during the BAT (middle panel), and therapist-rated fear during the BAT (right panel), by treatment condition.
Figure 3
Figure 3
Moderation of T2 general fear by acculturation level, median split (left panel), moderation of T2 catastrophic thinking by acculturation level, median split (middle panel), and moderation of T3 general fear by acculturation level, median split (right panel).
Figure 4
Figure 4
Independent coder ratings of culture-related and common therapy elements, by treatment condition.
See this image and copyright information in PMC

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