Adaptation of Transdiagnostic CBT for Turkish Adolescents: Examples From Culturally Adapted Multiplex CBT

Abstract

The present article illustrates how cognitive-behavioral therapy (CBT) was adapted for an adolescent Turkish population with mood and anxiety disorders. The resulting 10-session treatment-based on multiplex CBT-was efficacious in a treatment trial, showing large effect sizes (Acarturk et al., 2018). This paper discusses the cultural grounding of CBT, which increases effectiveness by such means as increasing acceptability and positive expectancy. We describe a culturally sensitive assessment measure of somatic complaints and cultural syndromes, the Turkish Symptom and Syndrome Addendum. We discuss how, in a culturally sensitive way, we normalized symptoms, conducted interoceptive exposure, and created positive reassociations to sensations. We describe how we used Turkish metaphors and religious ideas to teach CBT principles. We show how we adapted mindfulness and "loving kindness" for a Turkish population, and how we utilized transition "rituals" at the end of the treatment to give a sense of closure and a positive feeling of transformation. Two case examples are provided to further illustrate how we adapted multiplex CBT to a Turkish adolescent population.