Panel Discussion 11 - Is CBT Less Effective or Inappropriate for Non-white Clients? Research and Real World Clinical Perspectives

CBT is an umbrella term that encompasses many evidence-based strategies that have been shown to be efficacious in research and effective across real-world settings. A central tenet of CBT is implementation flexibly within fidelity (Kendall, 2008), which includes cultural and contextual adaptations,. It also involves testing interventions developed in one culture to determine applicability and utility in another (Hofmann, 2006). Nuances of ethnicity, race, and culture are ideally incorporated into a case conceptualization of patients’ learning histories and development of belief systems.  
Recently, some in the public and academic circles claim that CBT lacks applicability to racial/ethnic minority groups. CBT has been called a  colonization, oppression, and a gaslighting tool that undermines and invalidates racial/ethnic perspectives. This panel brings together researchers and clinicians of diverse backgrounds, who work with multicultural populations, experiencing a wide range of mental health concerns. We demonstrate the inherent flexibility and adaptability of CBT with diverse populations within the United States and across the globe, delivered in a culturally and contextually sensitive manner. Populations discussed include foreign, domestic, and immigrant Asian, Latino/a, Black/African American, and people from other backgrounds. 
Effectiveness of CBT in real-world clinical experiences across clinical settings and research findings for modalities such as ABA, ACT, CBT, DBT, TF-CBT, Behavioral Parent Training, and Family Based Therapy, are reviewed. We discuss potential circumstances for cultural and contextual adaptation, and the impact this has on actual CBT models. We summarize factors including outcomes, retention, and culturally adapted vs. unadapted implementation. Incorporating culture into case conceptualization and individualized treatment are considered. Cultural variations in values and socially acceptable behaviors and strengths-based approaches are discussed. We address provision of behavioral and mental health care in the context of disparities in access to, and knowledge of, resources. The impact of having multiple identities is examined. Practical advice for front line clinicians is discussed.