Cognitive-Behavioral Therapy for Immigrants Presenting With Social Anxiety Disorder: Two Case Studies

The Wright-Constantine Structured Cultural Interview and Integration of Culture into Case Conceptualization

Although multicultural counseling competence is crucial to the field of counseling psychology and clinical assessment, there remains a gap in how cultural data can be collected and used in clinical case conceptualization. The present study evaluated the case conceptualizations of doctoral-level trainees and focused on whether the integration of culture into the conceptualizations/formulations was influenced by the use of the Wright-Constantine Structured Cultural Interview (WCSCI), as compared to the use of one of two other cultural interviews (the Patient Cultural Identity Assessment and the DSM-5 Cultural Formulation Interview). Unsurprisingly, clients with minoritized identities and supervisors (but not trainees) with minoritized identities produced case conceptualizations that integrated culture at higher rates. Further, those conceptualizations that utilized the WCSCI were around 3.5 to 4.5 times more likely to integrate culture than those that used one of the other two cultural interviews. Implications for psychology practice are discussed.

Cognitive Behavioral Therapy for a Young Woman of Asian Heritage

Generalized anxiety disorder (GAD) is one of the most common anxiety disorders and is associated with significant impairments in academic, occupational, and social functioning. Cognitive behavioral therapy (CBT) has shown to be an effective treatment for GAD; however, little research has examined its effectiveness with individuals of Asian heritage. In fact, as a result of limited use of mental health services within the Asian population, there is little psychotherapy research for this population. The present case examined whether a well-established CBT protocol, Mastering Your Anxiety and Worry (MAW), can be tailored in a culturally responsive manner to consider factors and values that influence well-being and functioning. Treatment consisted of 27 sessions over a 6-month period, with outcome data demonstrating a significant decrease in anxiety symptoms at the end of treatment. Results revealed statistically reliable clinical change on the Depression, Anxiety, and Stress Scale–21 (DASS-21) using Western norms and norms for a Chinese sample. This case demonstrates the potential cross-cultural utility of CBT for GAD for individuals of Asian heritage.

Cultural modifications of cognitive behavioural treatment of social anxiety among culturally diverse clients: a systematic literature review

The aim of this study was to conduct a systematic literature review to ascertain whether cognitive behavioural therapy (CBT) for social anxiety disorder (SAD) can be successfully used in non-Western contexts and demonstrate sufficient effectiveness. This area is largely under-researched with conflicting evidence presented in quantitative studies, with virtually no qualitative studies published. This review utilized realist review methodology and focused on qualitative case studies presented by clinicians. A systematic search of EBSCO HOST, The Cochrane Library Database, Google, Google Scholar and reference mining, using various combinations of terms relating to: (1) CBT, (2) social anxiety and (3) cultural diversity were employed. Seven case studies of cultural adaptations of CBT treatment for culturally diverse SAD sufferers were included. The treatment outcomes were generally promising in all cases (reporting significant decrease of SAD symptoms, maintained over time) and the success of therapy was often attributed to culturally specific modifications introduced. CBT can be an acceptable and effective treatment for culturally diverse SAD sufferers with ‘modest’ modifications, without major diversions from the original CBT models and protocols, but this finding must be treated with caution and more methodologically rigorous research (qualitative and quantitative) is needed to more fully understand what works, for whom and in what circumstances.

Perfectionism in Language Learners

The pressures inherent in trying to be perfect can undermine learning and exacerbate anxiety in certain students. In the current article, we review existing research and theory on the role of perfectionism in language learning anxiety and performance deficits. Our analysis highlights the complexities inherent in the perfectionism construct, including the key distinction between personal and interpersonal perfectionism and the relevance of various components of the perfectionism construct when seeking to account for anxiety in language learners. A central theme in our analysis is how the cognitive tendencies as well as social pressures and self-presentational concerns that accompany perfectionism can exacerbate language learning anxiety and the subsequent emotional self-regulation responses of anxious learners. We outline a multifaceted model of perfectionism in language learning anxiety and language learning performance that incorporates trait perfectionism, perfectionistic cognitions, perfectionistic self-presentation, and individual differences in self-efficacy. Whereas personality is usually seen as a distal factor that contributes to language learning anxiety, we suggest that perfectionism can also act proximally by amplifying state-related, current concerns over making mistakes in language learning, especially in highly visible situations. The theoretical and practical implications of this theoretical framework are discussed. We conclude with a series of specific recommendations for teachers and school psychologists who must try to reduce levels of perfectionism and its impact among people trying too hard to minimize mistakes during the learning process.

Brand “you”: The emergence of social anxiety disorder in the age of enterprise

An historical ontology is conducted to identify conditions that led to the emergence of social anxiety disorder (SAD) in the late 20th century. Using Hacking’s (1998) ecological niche framework, SAD is analyzed in terms of four interrelated vectors (medical taxonomy, observability, cultural polarity, release) against the backdrop of neoliberal enterprise culture and its accompanying conception of the ideal self as confident, bold, and striving. The analysis suggests SAD has flourished as a consequence of a complex array of interrelated sociocultural and historical factors that have enabled social discomfort to be viewed as pathological while promoting its occurrence.