A Systematic Narrative Review of Cognitive-behavioral Therapies with Asian American Youth

ABSTRACT

Asian American (AsA) youth comprise a large and fast-growing proportion of the U. S. population. AsA youth have comparable and sometimes higher rates of mental health concerns compared to White youth, but are significantly less likely to access mental health services. Cognitive-behavioral therapy (CBT) was originally designed by and for White and Western populations, but might provide clinical benefits for AsA youth because several CBT characteristics overlap with some AsA values (e.g., directive therapeutic style; family involvement). Despite this promise, there has yet to be a synthesis of evidence on the effectiveness of CBT, either culturally-adapted or non-adapted, for AsA youth. A systematic narrative review identified randomized controlled trials (RCTs) of CBT conducted with AsA youth. Electronic databases used included PsycINFO, Web of Science, PubMed, and ProQuest. Our search yielded 2,059 articles, of which, 8 RCTs (386 participants) met inclusion criteria. Studies were heterogeneous across targeted problems (e.g., phobia, depression) and age (M = 8.4–22.1 years). Findings suggest that both culturally-adapted and non-adapted CBT (3 and 5 RCTs, respectively) were effective in reducing a range of emotional and behavioral problems for AsA youth. The dearth of studies with AsA youth underscores the need for enhancing the cultural responsiveness of clinical research and practice, as well as harnessing community-engaged methods to improve the accessibility and uptake of evidence-based mental health services for AsA youth.

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Notes

¹ Minoritization refers to being placed into a “minority” status reflecting historical and structural marginalization, rather than statistical underrepresentation (Sotto-Santiago, 2019).

² A microaggression refers to subtle, everyday communications that convey negative or denigrating racial insults toward minoritized groups (Sue et al., 2007).