Cultural suitability of schema therapy: a qualitative exploration of clinician views

• Published in: Australian journal of psychology 2024-12, Vol.76 (1)
• Main Authors: Martin, Irene R., Stewart, Sandra E., Tchernegovski, Phillip, Devenish, Bethany D.
• Format: Article
• Language: English
• Subjects: cultural adaptation; Cultural competence; reflexive thematic analysis; Schema therapy
• ISSN: 0004-9530; 1742-9536
• DOI: 10.1080/00049530.2024.2412012

ObjectiveThere is a growing popularity in the worldwide use of schema therapy (ST) to address a variety of psychological disorders. Yet, research into the cultural suitability of ST is scarce. This study aimed to explore ST clinicians’ experiences of the cultural suitability of ST.MethodEleven clinicians from nine countries were interviewed about their experiences of practising ST. Interviews were analysed using reflexive thematic analysis.ResultsTwo main themes, each with subthemes, were identified. The first theme was considerations for Cultural Context and Content: (i) Incongruence with Cultural Norms of Emotional Expression, (ii) “Maladaptive” or “Adaptive”, But in What Context?, and (iii) Issues Related to Familism when Addressing Parent/Critic Modes. The second theme focused on clinicians’ Cultural Competence: (i) Perceptions of Reduced Confidence and Competence in Providing Culturally Responsive Practice, and (ii) Clinicians’ Cultural Values Impacting ST Delivery. Participants discussed strategies to improve the cultural-responsiveness of ST, suggesting areas for further development.ConclusionPresent findings suggest that ST is not a one-size-fits-all approach, underscoring the need to improve the cultural responsiveness of ST, while better supporting clinicians to develop their cultural competence. Future research is needed to establish evidence-based cultural adaptations for ST.