Culturally-Tuned Depression Treatment is More Successful

Tailoring therapy and mental health intervention to the cultural needs of specific populations has proven effective in a recent study funded by the National Institute for Mental Health. The study took place at a community health center in Boston’s Chinatown and focused on reaching Chinese immigrants suffering from depression. Depression and other mental health conditions are often more prevalent in marginalized populations. And even among immigrants identified as depressed, just 6.5% entered treatment before the study. Factors keeping people out of therapy included a tradition of seeing doctors only for physical maladies, cultural stigma against mental health issues, and language barriers.

So, this particular program reached out to people to raise awareness and discuss mental health concerns in light of cultural values and beliefs. Depression screening became a regular part of physical exams at the community health center. Individuals who showed signs of depression were invited back for an assessment. This assessment included discussion of how the person’s thoughts and feelings impacted their daily life and what they hoped could be done about it. Then, often in the person’s native tongue, doctors would have one-on-one discussions about these concerns. Patients got to choose whether to work with a therapist or with their primary care physician to address their depression. Compared to the 6.5% who entered treatment before, 96% of those who came in for the assessment pursued treatment and saw significant improvement.

Basing treatment on the individual is a strong example of good therapy and counseling in practice. This isn’t the first example of culturally-sensitive success: we’ve written previously about culturally-informed resilience workshops for kids. And this applies not only to cultures but to individuals. No two people are the same, and everything from personal history to cultural background impacts how we perceive mental health issues, including depression. The more we base healing treatment on the unique needs of the person being treated, rather than generalities about the problem they’re facing, the better that treatment will be.

© Copyright 2010 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • suzie

    suzie

    November 23rd, 2010 at 10:11 AM

    it is definitely easier to actually explain your problem to someone in your native language and preferably to someone who understands your problem as a matter of fact(is from the same ethnic background).then there is the matter of certain problems being more prevalent in a particular ethnic group.all these factors make it difficult for a minority ethnic group to access healthcare.

  • Ron C

    Ron C

    November 24th, 2010 at 5:46 AM

    Still think that it is important to remember not to box people in and think that one therapy fits all, even if someone is from the same culture as another and a specific treatment worked in that case. Therapy and treatment needs to be careful to meet the individual needs of the person with who you are not working and not get roped into the thinking that would presume that what works for one person will necessarily work for someone else.

  • Neve

    Neve

    November 26th, 2010 at 9:18 PM

    The onus falls on the therapist to make the client feel they are being treated as an individual and not just one more person with the same old complaints. I guess like any job it can feel repetitive despite every case being truly unique.

  • Rachel

    Rachel

    November 27th, 2010 at 9:31 AM

    Some health professionals would do well to nurture their bedside manner. My mom talks about how our doctor knew every one of us inside out. You could meet him in the street and he would remember why you had been to see him last and would ask about us all by name. I’m talking about us kids, not just the adults. He didn’t need notes on his desk because he was dedicated to his calling.

  • robert

    robert

    November 27th, 2010 at 11:25 AM

    If there are language barriers, you can’t expect the counselor to be able to work optimally with a client. In a perfect world, we’d all speak each other’s languages and understand enough about different cultures to be sensitive to that too. That’s simply not the way it is.

  • Gabby

    Gabby

    November 27th, 2010 at 4:21 PM

    Well done Boston! They made the effort and were rewarded by success. Why can’t communities all over the country do the same thing? Interpreters can’t be that hard to find, especially if there’s a large segment of the population within the group.

  • julie

    julie

    November 27th, 2010 at 6:24 PM

    It shouldn’t matter if you’re in a minority or not. Everyone deserves to be heard and understood by their doctor or therapist and given individually tailored treatment.

  • Kevin

    Kevin

    November 27th, 2010 at 6:55 PM

    If we need more Chinese speaking therapists, health care providers can do the obvious: recruit them, and/or encourage existing therapists to learn Chinese and about China’s cultural heritage. I’m sure the companies would make their money back fast by closing that gap.

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