Culturally Adapting CBT for East Asian Youth in Ontario

Overview

This mixed methods study proposes a culturally adapted cognitive behavioural therapy (CA-CBT) model for an East Asian demographic in Canada. The client population of East Asian youth who have been diagnosed with anxiety and/or depression are the focus of the study. CBT has been proven as a very effective form of therapy, and when adapted can promote positive mental health outcomes for a growing and increasingly vulnerable population. Developing a culturally adapted version of CBT (CA-CBT) for this population adds a practical treatment that improves access to culturally relevant care.

Full Title of Study: “Improving Access to High Quality, Culturally Relevant Treatment for East Asian Canadian Youth in Ontario”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Single (Outcomes Assessor)
  • Study Primary Completion Date: September 18, 2019

Detailed Description

There is a major lack of culturally relevant mental health services for East Asian youth in Ontario and Canada. Beginning with a participatory/qualitative research approach, common themes amongst clients, caregivers, healthcare professionals, and community leaders, will divulge basic elements needed to develop a culturally adapted model of cognitive behavioural therapy. The information from the adapted model will be taught to participating psychologists who will deliver the therapy in a randomized control trial design, with feasibility testing of the intervention using a quantitative approach ensuing. Immediate guidelines will then be developed for use by therapists working with East Asian youth.

Interventions

  • Behavioral: Cognitive Behavioral Therapy
    • The intervention will be administered by therapists working at community agencies who are experienced at providing Cognitive Behavioral Therapy.

Arms, Groups and Cohorts

  • Experimental: Culturally adapted Cognitive Behavioral therapy
    • The experimental group will receive the culturally adapted version of cognitive behavioral therapy.
  • Active Comparator: Non-adapted Cognitive Behavioral therapy
    • The control group will receive the original (non-adapted) version of cognitive behavioral therapy.

Clinical Trial Outcome Measures

Primary Measures

  • Severity levels of depression and anxiety rated by the Hospital Anxiety and Depression Scale (HADS).
    • Time Frame: 4 months.
    • Severity levels of depression and anxiety will be rated pre- and post-intervention by the Hospital Anxiety and Depression Scale (HADS). The scale ranges from 0 to 21 for anxiety and 0 to 21 for depression. A score of 0 to 7 for depression and/or anxiety is considered a normal range. A score of 8 to 10 suggests the potential presence of depression and/or anxiety. A score of 11 or more suggests a likely presence of depression and/or anxiety.
  • Severity levels of depression and anxiety rated by the Bradford Somatic Inventory (BSI).
    • Time Frame: 4 months.
    • Severity levels of depression and anxiety will be rated pre- and post-intervention by the Bradford Somatic Inventory (BSI). The Bradford Somatic Inventory uses “yes” or “no” questions relating to somatic symptoms of anxiety and/or depression. A “yes” response to a question equates to a somatic symptom linked to depression and/or anxiety. The maximum number of “yes” responses is 46 and the minimum is 0. A higher number of “yes” responses suggests a potential increase in the severity of depression and/or anxiety.

Secondary Measures

  • Satisfaction of the culturally adapted Cognitive Behavioral Therapy assessed using the Verona Satisfaction Scale.
    • Time Frame: 4 months.
    • Satisfaction will be measured using the Verona Satisfaction Scale. This scale measures patients satisfaction with health care services. The items are rated by 4 categories labelled: “strongly disagree”, “disagree”, “agree”, and “strongly agree”, on a scale of 1 to 4. A higher sub-scale/domain score indicates better satisfaction. All sub-scales are summed up to compute total/domain score. This scale will be used to identify the strengths and weaknesses of the therapy service and provide guidance for further development.

Participating in This Clinical Trial

Inclusion Criteria

  • Self identification as East Asian origin
  • Between the ages of 12 to 21
  • Diagnosed as having depression and/or anxiety

Exclusion Criteria

  • Have been affected by psychosis
  • Have been affected by serious addiction
  • Have been affected by cognitive impairment

Gender Eligibility: All

Minimum Age: 12 Years

Maximum Age: 21 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Centre for Addiction and Mental Health
  • Collaborator
    • East Metro Youth Services
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Farooq Naeem, M.D., Principal Investigator, Centre for Addiction and Mental Health
    • Myra Levy, M.A., Study Director, East Metro Youth Services
  • Overall Contact(s)
    • Myra Levy, 416-438-3697, mlevy@emys.on.ca

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