Abstract
Large scale studies such as the National Latino and Asian American Study (NLAAS; Alegria et al., 2004) and Chinese American Psychiatric Epidemiological Study (CAPES; Takeuchi et al., 1998) demonstrated ethnic and racial disparities in mental health service use, with unique barriers to quality of care due to their social position, environmental context, and psychosocial factors. Although there is a growing body of literature that demonstrates the effectiveness of empirically supported treatments with depressed African Americans and Latino/as (Miranda et al., 2003a; 2003b), research examining treatment outcome among Asian Americans continues to be limited. This study examined the impact of gender and culturally adapted treatment on help-seeking attitudes in clinically depressed Chinese Americans. Archival data was extracted from a 12-week clinical trial comparing standard cognitive-behavioral therapy (CBT) and culturally adapted CBT (CA-CBT). The sample in the study was comprised of 50 adult Chinese Americans (72% female, mean age 45 years) who met criteria for DSM-IV criteria major depressive disorder. The Attitude Toward Seeking Professional Psychological Help Scale – Short Form (Fischer & Farina, 1995) was used at baseline and at the end of treatment to measure help-seeking attitudes. Results indicate that male participants held more negative attitudes than their female counterparts at the beginning of treatment; however, they were able to shift their attitudes after receiving 12 sessions of evidence-based treatment. Although culturally-adapted treatments are designed to improve cultural competency in service delivery, such intervention was not shown to significantly improve help-seeking attitudes in this study. Rather, exposure to 12 sessions of psychotherapy led to a decrease in depressive symptoms, which ultimately contributed to an increase in men's help-seeking attitudes. This supports the notion that utilization of mental health services in Asian Americans is impacted by complex factors operating at multiple levels. The use of culturally adapted psychotherapy is only one component of culturally appropriate service delivery, and clinicians will need to adapt their approach in advertisement and recruitment of clients to circumvent stigma around seeking help.