Culturally Adapting CBT for East Asian Youth in Ontario

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Improving Access to High Quality, Culturally Relevant Treatment for East Asian Canadian Youth in Ontario

Conditions
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Anxiety, Depression

Intervention / Treatment
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* Behavioral: Cognitive Behavioral Therapy


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: East Asian youth diagnosed with Anxiety and/or depression will be randomly assigned to either the experimental group (receives the cultural adapted version of cognitive behavioral therapy) or the control group (non-culturally adapted cognitive behavioral therapy). It is a randomized control trial design.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Culturally adapted Cognitive Behavioral therapy<br>The experimental group will receive the culturally adapted version of cognitive behavioral therapy. | Behavioral: Cognitive Behavioral Therapy<br>* The intervention will be administered by therapists working at community agencies who are experienced at providing Cognitive Behavioral Therapy.<br>|
| Active Comparator: Non-adapted Cognitive Behavioral therapy<br>The control group will receive the original (non-adapted) version of cognitive behavioral therapy. | Behavioral: Cognitive Behavioral Therapy<br>* The intervention will be administered by therapists working at community agencies who are experienced at providing Cognitive Behavioral Therapy.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Severity levels of depression and anxiety rated by the Hospital Anxiety and Depression Scale (HADS). | 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. | 4 months. | 
| Severity levels of depression and anxiety rated by the Bradford Somatic Inventory (BSI). | 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. | 4 months. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Satisfaction of the culturally adapted Cognitive Behavioral Therapy assessed using the Verona Satisfaction Scale. | 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. | 4 months. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cognitive Behavioral Therapy, Cultural Adaptation, East Asian Youth