CBT is the ‘gold standard’, but is that just for white people?

Provocative title.

Still, I'm not convinced CBT works very well at all for just about anyone. Obviously all anecdote, but literally anyone I know that has had cause to interact with therapists has seemingly independantly come to the conclusion that they need to immediately stop any psychologist trying to explain CBT to them and ask if they know any other techniques, and if the answer isn't an alternative, to just find a new therapist. It's laughably bad.

Therapy, especially something very surface-level like CBT, is less efficacious when your daily life actually generally sucks. Depression is a rational response to a shitty life that doesn't seem to be getting better any time soon. Anxiety and hypervigilance are rational responses to some kinds of difficult-to-escape toxic relationships.

It didn't start working for me until I separated from my birth family.

I completely buy that, in addition to what the article says, minorities have a rougher time with cognitive therapy because their life tends to suck more on average, in ways that you can't think your way out of.

For those checking comments first, this is about cognitive behavioural therapy, not marijuana or that other thing.

This article makes no claim as to why CBT may work better for white people—except for a few one-off muses about authority or family structure—which I find to be more interesting than what they're actually talking about. Maybe CBT is more effective for white people because it operates on a set of assumptions that align with Western values, in which case, since most white people are western, it would work better for them. One way to test that would be to find non-white people who broadly follow western norms, have a native language of English, and are assimilated into american culture, and see if there's a difference.

Perhaps this difference is also caused by wealth, many of the examples listed are of refugees and recent immigrants to the US, groups who are probably poorer than the average American. Maybe since white people are simply richer (*on average) and have less cognitive stress from being poorer, CBT tends to work better for them. In this case, design a study to see whether the race effects persist when adjusting for income.

Is there a name for this phenomenon I've noticed in things like evidence-based practice:

Phase I: On average, our averages show that X is successful/X does Y.

[The Science™ sez X! We must all do X now!]

Phase II: Wait! Those averages only apply to a specific subset of the cases and don't consider the outliers, which, to our complete and total surprise, behave somewhat differently!

This article was valuable to me.

My fiancee's close family, and myself, have been trying to convince her to go to therapy for anger issues. She's always refused and stated that therapy is just for weaklings / white people. If her mom could survive near-death experiences during the Khmer Rouge and not need therapy, then she didn't need it either... So the opening example of Khmer Rouge survivors receiving CBT was a perfect introduction to this article. I really hope she connects with the topic and considers giving therapy a chance.

Also, about this example further in:

>One study (an unpublished doctoral thesis) mentioned in the review found that cultural adaptation – in terms of the languages used and the ethnicity of people involved – led to worse therapeutic outcomes. Hispanic college students who had phobias around giving speeches went through a video-feedback-based treatment in either English, or English and Spanish, and they practised giving speeches either in front of a white or a Hispanic audience. The participants who gave speeches in English to white audiences showed greater reductions in anxiety than the other groups.

One possible explanation is that the Hispanic speakers felt a greater amount of anxiety from a Spanish-speaking audience due to greater cultural expectations. So rather than English being some kind of special anxiety-lessening language, it's more likely (IMHO) that any language other than their first one (e.g., Spanish) would have resulted in an audience with lower speaking standards expectations for the speaker to worry about.

Tangentially, Slavoj Zizek often tells an anecdote of how while in India, some less-affluent people told him that they preferred English because their native Hindi dialects are just embedded with hierarchy and class stratification. I don't know if this is really the case, but if it is, then Zizek's assertion that revolutionary thought can require new language is an interesting one.

Even more tangentally, I am reminded of how I can type better in Dvorak, not just because it is more efficient than QWERTY, but because learning it forced me to drop the bad habits I had carried with me over the years from when I first began using a keyboard to play simple computer games in the late 90s.

Overall the theme is apparently a clean slate / new environment / blank canvas / fresh perspective can be instrumental for transformation.

I'm not sure about this. What are people's experience with CBT? Personally I've gained a lot of insight from psychoanalysis in a more traditional framework.

If anything CBT has some weird religious undercurrent, Protestant flavored, "don't sin! Think the right things"

CBT = Cognitive Behavioural Therapy

It seems the actual question is “Does CBT work better for non-white people when therapy is culturally adapted tlfor them”.