Let's continue our discussion with a terrific article (Hays, 2009), which includes specific suggestions for and examples of the integration of cultural considerations into CBT.

I wonder if, considering our discussion prompt and building off this article, we might further conceptualize specific cultural adaptations by picking one of the 10 suggestions and extrapolating what that might look like with either Sandra and Andy or Josh and Lisa.

Hays, P. A. (2009). Integrating evidence-based practice, cognitive-behavior therapy, and multicultural therapy: Ten steps for culturally competent practice. Professional Psychology:Research and Practice, 40(4), 354-360.https://doi.org/10.1037/a0016250

Case study:

Josh is a 41-year-old who is in Construction. Ten months ago he was promoted as a Project Manager for a construction company. With this promotion he had to transfer from a rural location in Ontario and travel to Ottawa 250 kilometres away from his family. He works long hours and must start very early each day. He travels back on the weekends to see his family. He has a wife and 3 children to support.

His wife Lisa is 38 years old and works 3 days per week as a personal support worker (PSW) for an elderly woman. She now regrets the decision they both made for Josh to work so far away. The weekends he comes back to the family and when he does return, all they seem to do is argue. The arguments get heated. Lisa begins to scream and Josh slams doors to get away from Lisa. Lisa is frightened that her marriage will fail and is worried about her kids. She is also concerned Josh has found another woman (Josh had an affair 10 years earlier soon after they had married). They both decided to come for marriage counselling.