title: Culturally adapted versus standard exposure treatment for phobic Asian Americans: Treatment efficacy, moderators, and predictors.
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.
authors.affiliation: Department of Psychology, University of Southern California, SGM 501, 3620 S. McClintock Avenue, Los Angeles, CA 90089-1061, USA. davidpan@usc.edu or hueyjr@usc.edu
authors.forename: David
authors.initials: D
authors.lastname: Pan
authors.forename: Stanley J
authors.initials: SJ
authors.lastname: Huey
authors.forename: Dominica
authors.initials: D
authors.lastname: Hernandez
mesh_terms: D000069:Acculturation; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001213:Asian / Q000523:psychology*; D001521:Behavior Therapy / Q000379:methods*; D058443:Catastrophization; D003469:Culture; D005239:Fear; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D008297:Male; D010698:Phobic Disorders / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology / Q000628:therapy*; D011613:Psychotherapy / Q000379:methods*; D057566:Self Report; D016896:Treatment Outcome; D055815:Young Adult