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Cultural Adaptation of CBT for Serious Mental Illness: A Guide for Training and Practice

ISBN: 978-1-118-97620-3
352 pages
May 2015, Wiley-Blackwell
Cultural Adaptation of CBT for Serious Mental Illness: A Guide for Training and Practice (1118976207) cover image


  • A comprehensive guide designed to enable CBT practitioners to effectively engage people from diverse cultural backgrounds by applying culturally-sensitive therapeutic techniques
  • Adapts core CBT techniques including reattribution, normalization, explanation development, formulating, reality testing, inference chaining and resetting expectations
  • High profile author team includes specialists in culturally-sensitive CBT along with world-renowned pioneers in the application of CBT to serious mental illness
  • Contains the most up-to-date research on CBT in ethnic minority groups available
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Table of Contents

About the Authors vii

Foreword ix

Preface xi

Acknowledgements xiii

1 Introduction 1

2 Cultural Adaptation of Cognitive Behavioural Therapy: Principles and Challenges 14

3 Philosophical Orientation and Ethical and Service Considerations 46

4 The Therapeutic Relationship and Technical Adjustments 86

5 General Theoretical Modifications in Orienting Clients to Therapy 121

6 Individualized Case Formulation 135

7 Individualized Treatment Planning 165

8 Psychosis: Cultural Aspects of Presentation and Adaptations to Treatment 192

9 Depression: Cultural Aspects of Presentation and Adaptations to Treatment 227

10 Bipolar Affective Disorder: Cultural Aspects of Presentation and Adaptations to Treatment 248

11 Recovery, Relapse Prevention, and Finishing Therapy 273

12 Policy and Training Implications 293


1 Social Factors: My Immigration Journey 306

2 Aida – Longitudinal Formulation 308

3 Setting Goals to Improve Quality of Life 310

4 Voices Diary 312

5 What Do Voices Say? 314

6 Working on Coping Strategies: Pleasant Events Schedule 315

7 Preventing a Relapse or Breakdown 317

8 Circle of Support 320

9 Relapse Prevention Plans 322

Index 326

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Author Information

Dr Shanaya Rathod is a Consultant Psychiatrist, Clinical Services Director and Director of Research at Southern Health NHS Foundation Trust, UK. Dr Rathod has been a Fellow of the National Institute for Health and Care Excellence. She has published a number of papers in peer reviewed journals, book chapters, and books including, Back to Life, Back to Normality: Cognitive Therapy, Recovery and Psychosis (2009).

David Kingdon is Professor of Mental Health Care Delivery at the University of Southampton, UK, and Honorary Consultant Adult Psychiatrist for Southern Health NHS Foundation Trust. He has previously worked as Medical Director for Nottingham Health Care Trust and Senior Medical Officer (Severe Mental Illness) in the UK Department of Health. He now does policy and implementation work for NHS England and is editor of their mental health websites.

Dr Narsimha R Pinninti is Professor of Psychiatry at the Rowan University School of Osteopathic Medicine and Chief Medical Officer for Twin Oaks Community Services in New Jersey, USA. A certified cognitive therapist and psychiatrist for the Assertive Community Treatment Team, Dr Pinninti has published over 40 articles in peer reviewed journals and authored two manuals on how to teach Cognitive Behavioural Therapy interventions for case managers and clients.

Douglas Turkington is Professor of Psychosocial Psychiatry at Newcastle University, UK. Professor Turkington is an expert on the efficacy and effectiveness of cognitive behavioural therapy (CBT) in the treatment of schizophrenia. A fellow of the Royal College of Psychiatrists and founding fellow of the Faculty of Cognitive Therapy in Philadelphia, he has written more than 100 articles on the subject of CBT in schizophrenia.

Dr Peter Phiri, PhD is a Cognitive Behaviour Therapy Specialist and Research & Development Manager (Interim) at Southern Health NHS Foundation Trust and Honorary Lecturer at the University of Southampton, UK. He is an accredited member of the British Association of Behavioural and Cognitive Psychotherapy.
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This book pulls all the current data on the effectiveness of culturally sensitive CBT in this area as well as providing clinicians with a manual to learn and practice culturally informed CBT. I can confidently recommend it as helpful for anyone working with severely mentally ill clients.—Aaron T. Beck, M.D., University Professor Emeritus of Psychiatry, University of Pennsylvania 

This volume offers a practical guide to culturally adapting CBT for severe mental health conditions. The authors are gifted clinicians and investigators that present a sophisticated overview of key conceptual and pragmatic issues in working with diverse communities. The book proposes novel concepts and applications of a well-established evidenced-based treatment in which language, culture, race, and ethnicity, are integral to the conceptualization and process of therapy.  This book is a remarkable contribution to the growing literature on cultural adaptations and as such it represents a major contribution to multicultural psychology and mental health. This is essential reading for clinicians and scholars interested in working with the diverse majority-world communities.—Guillermo Bernal, Ph.D., Director, Institute for Psychological Research, University of Puerto Rico, Rio Piedras, Puerto Rico

There was a time when psychological therapies were not thought to be appropriate for all patients, especially those of low socio-economic or poor educational status, and ethnic minorities, refugees, migrants or people from low and middle-income countries. Clinicians did not have the tools to adapt their skills. No more! Combining psychoanalytic, cognitive behavioural and general therapeutics theory with evidence on the cultural adaptation of psychological therapies, this impressive, accessible and timely volume offers hope to patients of diverse cultural heritage, beliefs, and practices.—Kamaldeep Bhui, Professor of Cultural Psychiatry & Epidemiology, Queen Mary University of London 

In a globalized world we need methods to adapt interventions so they are equally effective for different groups.  One size fits all and culture and color blind approaches hardwire inequity. Many have undertaken cultural adaptations but to have some of the major voices in CBT produce guidance on cultural adaptation produces a priceless treasure.  Whether you are developing services in a low income country or for marginalised groups in a high income country this book will help you produce the most effective CBT for the people you serve.—Kwame McKenzie M.D. FRCPsych (UK), Medical Director CAMH, Professor of Psychiatry University of Toronto 

"With its clear, thoughtful prose and its diverse, vivid case examples, this guide will help CBT practitioners sensitively handle the challenges of working with individuals and families from a wide variety of cultural, religious, and spiritual backgrounds.  By using these approaches, unique and thorny challenges to the cross cultural application of CBT can be creatively and collaboratively addressed and resolved."—Ron Unger 

"Culturally informed mental health care is rapidly moving from an attitudinal orientation to an evidence-based approach. This textbook makes an important contribution towards understanding the conceptual basis and evidence behind cultural adaptation of cognitive behavioral therapy, but also provides clinical and contextual guidance in application for diverse populations and serious psychiatric disorders. A must-read for the clinician who wishes to serve the majority of patients we will be serving as cultural plurality is achieved in the US and globally."—Andres J Pumariega, M.D., Professor and Chair, Cooper Medical School of Rowan University and Cooper Health System

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