Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-26T07:01:26.619Z Has data issue: false hasContentIssue false
  • English
  • Français

Cultural adaptations of cognitive behaviour therapy for the Orthodox Jewish community: a qualitative study of therapists’ perspectives

Part of: Being an Anti-Racist CBT therapist

Published online by Cambridge University Press:  19 January 2021

Chaim Golker Open the ORCID record for Chaim Golker [Opens in a new window]  and
Maria Cristina Cioffi Open the ORCID record for Maria Cristina Cioffi [Opens in a new window]
Chaim Golker
Affiliation:
Department of Social, Therapeutic and Community Studies, Goldsmiths, University of London, London, UK Hertfordshire Partnership University NHS Foundation Trust, UK
Maria Cristina Cioffi*
Affiliation:
Department of Social, Therapeutic and Community Studies, Goldsmiths, University of London, London, UK
*
*Corresponding author. Email: m.cioffi@gold.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Cultural factors are influential in the prevalence, diagnosis and treatment efficacy of mental health conditions. Although the literature has advanced substantially towards the development of cultural adaptations of cognitive behavioural therapy (CBT) for various minority cultural groups, research into cultural adaptations of CBT for the Orthodox Jewish community has been scarce. This qualitative study interviewed five CBT therapists about their experiences working with clients from the London Orthodox Jewish community and uncovered several key practical implications for the clinical practice of CBT with this client group. This study indicates that CBT is a culturally appropriate psychological treatment for this client group that accords with Orthodox Jewish teachings and religious beliefs. CBT therapists are encouraged to become familiar with Orthodox Jewish cultural practices and beliefs and adopt a culturally sensitive approach to treatment. Despite the reduced mental health stigma within the community, this study recommends that CBT therapists normalise mental health conditions and therapy with Orthodox Jewish clients. Due to the close-knit nature of the community, it is suggested that CBT therapists display heightened confidentiality with this client group. To overcome the mistrust of their Orthodox Jewish clients, CBT therapists are advised to display cultural sensitivity and genuine respect for the Orthodox Jewish way of life, in addition to building a strong therapeutic alliance. Further qualitative research exploring different perspectives is necessary to produce evidence-based guidelines for the cultural adaptation of CBT for the Orthodox Jewish community.

Key learning aims

  1. (1) To explore how CBT therapists work with the religious beliefs and practices of Orthodox Jewish clients.

  2. (2) To discover the challenges faced by Orthodox Jewish clients when accessing psychological treatment.

  3. (3) To consider the ways in which CBT can be culturally adapted to meet the needs of the Orthodox Jewish community.

Keywords

CBTcultureJewishOrthodoxreligiontherapy
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 14 , 2021 , e3
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Further reading

Kada, R. (2019). Cultural adaptations of CBT for the British Jewish Orthodox community. The Cognitive Behaviour Therapist, 12, 1–9.CrossRefGoogle Scholar
Paradis, C. M., Friedman, S., Hatch, M. L., & Ackerman, R. (1996). Cognitive behavioral treatment of anxiety disorders in Orthodox Jews. Cognitive and Behavioral Practice, 3, 271–288.CrossRefGoogle Scholar
Rosmarin, D. H., Bocanegra, E. S., Hoffnung, G., & Appel, M. (2019). Effectiveness of cognitive behavioral therapy for anxiety and depression among Orthodox Jews. Cognitive and Behavioral Practice, 26, 676–687.CrossRefGoogle Scholar
Shabtai, D. G., Pirutinsky, S., Rosmarin, D. H., & Ives, Y. (2016). Integrating Judaism into Cognitive Behavioral Therapy. In Ben-Avie, M., Ives, Y., & Loewenthal, K. (eds), Applied Jewish Values in Social Sciences and Psychology (pp. 133–149). Cham, Switzerland: Springer.CrossRefGoogle Scholar

References

Beck, A. (2016). Transcultural Cognitive Behaviour Therapy for Anxiety and Depression: A Practical Guide. Routledge.CrossRefGoogle Scholar
Benish, S. G., Quintana, S., & Wampold, B. E. (2011). Culturally adapted psychotherapy and the legitimacy of myth: a direct-comparison meta-analysis. Journal of Counseling Psychology, 58, 279–289. https://doi.org/10.1037/a0023626 CrossRefGoogle ScholarPubMed
Bernal, G., Jiménez-Chafey, M. I., & Domenech Rodríguez, M. M. (2009). Cultural adaptation of treatments: a resource for considering culture in evidence-based practice. Professional Psychology: Research and Practice, 40, 361–368. https://doi.org/10.1037/a0016401 CrossRefGoogle Scholar
Bilu, Y., & Witztum, E. (1993). Working with Jewish ultra-orthodox patients: guidelines for a culturally sensitive therapy. Culture, Medicine and Psychiatry, 17, 197–233. https://doi.org/10.1007/BF01379326 CrossRefGoogle ScholarPubMed
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101. https://doi.org/10.1191/1478088706qp063oa CrossRefGoogle Scholar
David, D., Cristea, I., & Hofmann, S. G. (2018). Why cognitive behavioral therapy is the current gold standard of psychotherapy. Frontiers in Psychiatry, 9. https://doi.org/10.3389/fpsyt.2018.00004 CrossRefGoogle Scholar
Dobson, D. J. G., & Dobson, K. S. (2009). Evidence-Based Practice of Cognitive-Behavioral Therapy. Guilford Press.Google Scholar
Flasch, P., & Fulton, C. L. (2019). Counseling Jewish Americans: considerations for practice. Counseling and Values, 64, 2–19. https://doi.org/10.1002/cvj.12091 CrossRefGoogle Scholar
Gehl, N. (2014). Jewish care and counseling. In D. A. Leeming (ed), Encyclopedia of Psychology and Religion (pp. 913–916). Springer. https://doi.org/10.1007/978-1-4614-6086-2_9239 CrossRefGoogle Scholar
Graham, D., & Vulkan, D. (2008). Population Trends among Britain’s Strictly Orthodox Jews. Board of Deputies of British Jews.Google Scholar
Greenberg, D., & Shefler, G. (2008). Ultra-Orthodox rabbinic responses to religious obsessive-compulsive disorder. The Israel Journal of Psychiatry and Related Sciences, 45, 183–192.Google ScholarPubMed
Greenberg, D., & Witztum, E. (2013). Challenges and conflicts in the delivery of mental health services to Ultra-Orthodox Jews. Asian Journal of Psychiatry, 6, 71–73. https://doi.org/10.1016/j.ajp.2012.10.008 CrossRefGoogle ScholarPubMed
Guo, F., & Hanley, T. (2015). Adapting cognitive behavioral therapy to meet the needs of Chinese clients: opportunities and challenges. PsyCh Journal, 4, 55–65. https://doi.org/10.1002/pchj.75 CrossRefGoogle ScholarPubMed
Haimovich, M., & Leiser, D. (2017). Ultra-Orthodox Jewish perceptions of psychotherapy and psychopathology. Bar-Ilan University Press, 32.Google Scholar
Hall, G. C. N., Yip, T., & Zárate, M. A. (2016). On becoming multicultural in a monocultural research world: a conceptual approach to studying ethnocultural diversity. American Psychologist, 71, 40–51. https://doi.org/10.1037/a0039734 CrossRefGoogle Scholar
Hinton, D. E., & Patel, A. (2017). Cultural adaptations of cognitive behavioral therapy. Psychiatric Clinics of North America, 40, 701–714. https://doi.org/10.1016/j.psc.2017.08.006 CrossRefGoogle ScholarPubMed
Holliman, R., & Wagner, A. (2015). Responsive counseling in Jewish Orthodox communities. Journal of Counselor Practice, 6, 56–75. https://doi.org/10.22229/joc038712 Google Scholar
Horowitz, M., & Milevsky, A. (2020). Interpersonal processes in homogeneous group therapy with Orthodox Jewish men in Israel: case example and clinical application. International Journal of Group Psychotherapy, 70, 509–539. https://doi.org/10.1080/00207284.2020.1805619 CrossRefGoogle Scholar
Huppert, J. D., Siev, J., & Kushner, E. S. (2007). When religion and obsessive–compulsive disorder collide: treating scrupulosity in Ultra-Orthodox Jews. Journal of Clinical Psychology, 63, 925–941. https://doi.org/10.1002/jclp.20404 CrossRefGoogle ScholarPubMed
Kada, R. (2019). Cultural adaptations of CBT for the British Jewish Orthodox community. The Cognitive Behaviour Therapist, 12, 1–9. https://doi.org/10.1017/S1754470X18000120 CrossRefGoogle Scholar
Kirmayer, L. J. (2012). Rethinking cultural competence. Transcultural Psychiatry, 49, 149–164. https://doi.org/10.1177/1363461512444673 CrossRefGoogle ScholarPubMed
Laungani, P. D. (2004). Counselling and therapy in a multi-cultural setting. Counselling Psychology Quarterly, 17, 195–207. https://doi.org/10.1080/09515070410001728262 CrossRefGoogle Scholar
Lightman, E. S., & Shor, R. (2002). Askanim: informal helpers and cultural brokers as a bridge to secular helpers for the Ultra-Orthodox Jewish communities of Israel and Canada. Families in Society: The Journal of Contemporary Social Services, 83, 315–324. https://doi.org/10.1606/1044-3894.26 CrossRefGoogle Scholar
Lincoln, Y., & Guba, E. G. (1985). Naturalistic Inquiry. Newbury Park, CA, USA: Sage.CrossRefGoogle Scholar
McEvoy, P., Williamson, T., Kada, R., Frazer, D., Dhliwayo, C., & Gask, L. (2017). Improving access to mental health care in an Orthodox Jewish community: a critical reflection upon the accommodation of otherness. BMC Health Services Research, 17, 557–572. https://doi.org/10.1186/s12913-017-2509-4 CrossRefGoogle Scholar
McIntosh, M. J., & Morse, J. M. (2015). Situating and constructing diversity in semi-structured interviews. Global Qualitative Nursing Research. https://doi.org/10.1177/2333393615597674 CrossRefGoogle ScholarPubMed
McMain, S., Newman, M. G., Segal, Z. V., & DeRubeis, R. J. (2015). Cognitive behavioral therapy: current status and future research directions. Psychotherapy Research: Journal of the Society for Psychotherapy Research, 25, 321–329. https://doi.org/10.1080/10503307.2014.1002440 CrossRefGoogle ScholarPubMed
Milevsky, A., Niman, D. S., Raab, A., & Gross, R. (2011). A phenomenological examination of dating attitudes in ultra-orthodox Jewish emerging adult women. Mental Health, Religion & Culture, 14, 311–322. https://doi.org/10.1080/13674670903585105 CrossRefGoogle Scholar
Milevsky, A., & Eisenberg, M. (2012). Spiritually oriented treatment with Jewish clients: meditative prayer and religious texts. Professional Psychology: Research and Practice, 43, 336–340. https://doi.org/10.1037/a0028035 CrossRefGoogle Scholar
Naeem, F., Phiri, P., Nasar, A., Gerada, A., Munshi, T., Ayub, M., & Rathod, S. (2016). An evidence-based framework for cultural adaptation of cognitive behaviour therapy: process, methodology and foci of adaptation. World Cultural Psychiatry Research Review, 11, 61–70. https://doi.org/10.1017/S1754470X18000247 Google Scholar
Nezu, C. M., & Nezu, A. M. (2015). The Oxford Handbook of Cognitive and Behavioral Therapies. Oxford University Press.CrossRefGoogle Scholar
Ng, T. K., & Wong, D. F. K. (2017). The efficacy of cognitive behavioral therapy for Chinese people: a meta-analysis. Australian & New Zealand Journal of Psychiatry, 52, 620–637. https://doi.org/10.1177/0004867417741555 CrossRefGoogle ScholarPubMed
Nowell, L. S., Norris, J. M., White, D. E., & Moules, N. J. (2017). Thematic analysis: striving to meet the trustworthiness criteria. International Journal of Qualitative Methods, 16, 1–13. https://doi.org/10.1177/1609406917733847 CrossRefGoogle Scholar
Paradis, C. M., Friedman, S., Hatch, M. L., & Ackerman, R. (1996). Cognitive behavioral treatment of anxiety disorders in Orthodox Jews. Cognitive and Behavioral Practice, 3, 271–288. https://doi.org/10.1016/S1077-7229(96)80018-6 CrossRefGoogle Scholar
Pirutinsky, S., Rosen, D. D., Shapiro Safran, R., & Rosmarin, D. H. (2010). Do medical models of mental illness relate to increased or decreased stigmatization of mental illness among Orthodox Jews? The Journal of Nervous and Mental Disease, 198, 508–512. https://doi.org/10.1097/NMD.0b013e3181e07d99 CrossRefGoogle ScholarPubMed
Prijs, S. (2019). Mental health attitudes and help seeking in Hareidi Jewish communities in the U.K. Unpublished undergraduate dissertation, BPP University.Google Scholar
Rathod, S., Gega, L., Degnan, A., Pikard, J., Khan, T., Husain, N., Munshi, T., & Naeem, F. (2018). The current status of culturally adapted mental health interventions: a practice-focused review of meta-analyses. Neuropsychiatric Disease and Treatment, 14, 165–178. https://doi.org/10.2147/NDT.S138430 CrossRefGoogle ScholarPubMed
Rathod, S., Phiri, P., & Naeem, F. (2019). An evidence-based framework to culturally adapt cognitive behaviour therapy. The Cognitive Behaviour Therapist, 12. https://doi.org/10.1017/S1754470X18000247 CrossRefGoogle Scholar
Rosmarin, D. H., Pargament, K. I., Pirutinsky, S., & Mahoney, A. (2010). A randomized controlled evaluation of a spiritually integrated treatment for subclinical anxiety in the Jewish community, delivered via the Internet. Journal of Anxiety Disorders, 24, 799–808. https://doi.org/10.1016/j.janxdis.2010.05.014 CrossRefGoogle Scholar
Rosmarin, D. H., Bocanegra, E. S., Hoffnung, G., & Appel, M. (2019). Effectiveness of cognitive behavioral therapy for anxiety and depression among Orthodox Jews. Cognitive and Behavioral Practice, 26, 676–687. https://doi.org/10.1016/j.cbpra.2019.07.005 CrossRefGoogle Scholar
Rosmarin, D. H., & Pirutinsky, S. (2020). Do religious patients need religious psychotherapists? A naturalistic treatment matching study among Orthodox Jews. Journal of Anxiety Disorders, 69, 102170. https://doi.org/10.1016/j.janxdis.2019.102170 CrossRefGoogle ScholarPubMed
Rowland, G. (2016). How do Parents within the Orthodox Jewish Community Experience Accessing a Community Child and Adolescent Mental Health Service? Doctoral dissertation, University of East London.Google Scholar
Schlosser, L. Z., Ali, S. R., Ackerman, S. R., & Dewey, J. J. H. (2009). Religion, ethnicity, culture, way of life: Jews, Muslims, and multicultural counseling. Counseling and Values, 54, 48–65. https://doi.org/10.1002/j.2161-007X.2009.tb00004.x CrossRefGoogle Scholar
Schnall, E. (2006). Multicultural counseling and the Orthodox Jew. Journal of Counseling & Development, 84, 276–282. https://doi.org/10.1002/j.1556-6678.2006.tb00406.x CrossRefGoogle Scholar
Schnall, E., Eichenbaum, B., & Abramovitz, Y. (2016). Jewish stories in mental health counseling. Journal of Creativity in Mental Health, 11, 12–26. https://doi.org/10.1080/15401383.2015.1130667 CrossRefGoogle Scholar
Schnall, E., Kalkstein, S., Gottesman, A., Feinberg, K., Schaeffer, C. B., & Feinberg, S. S. (2014). Barriers to mental health care: a 25-year follow-up study of the Orthodox Jewish community. Journal of Multicultural Counseling and Development, 42, 161–173. https://doi.org/10.1002/j.2161-1912.2014.00052.x CrossRefGoogle Scholar
Shabtai, D. G., Pirutinsky, S., Rosmarin, D. H., & Ives, Y. (2016). Integrating Judaism into cognitive behavioral therapy. In Ben-Avie, M., Ives, Y., & Loewenthal, K. (eds), Applied Jewish Values in Social Sciences and Psychology (pp. 133–149). Springer.CrossRefGoogle Scholar
Stolovy, T., Levy, Y. M., Doron, A., & Melamed, Y. (2013). Culturally sensitive mental health care: a study of contemporary psychiatric treatment for Ultra-Orthodox Jews in Israel. International Journal of Social Psychiatry, 59, 819–823. https://doi.org/10.1177/0020764012461206 CrossRefGoogle ScholarPubMed
Strean, H. S. (1994). Psychotherapy with the Orthodox Jew. Jason Aronson.Google Scholar
Sue, S., Zane, N., Nagayama Hall, G. C., & Berger, L. K. (2009). The case for cultural competency in psychotherapeutic interventions. Annual Review of Psychology, 60, 525–548. https://doi.org/10.1146/annurev.psych.60.110707.163651 CrossRefGoogle ScholarPubMed
Waller, G. (2009). Evidence-based treatment and therapist drift. Behaviour Research and Therapy, 47, 119–127. https://doi.org/10.1016/j.brat.2008.10.018 CrossRefGoogle ScholarPubMed
Waller, G., & Turner, H. (2016). Therapist drift redux: why well-meaning clinicians fail to deliver evidence-based therapy, and how to get back on track. Behaviour Research and Therapy, 77, 129–137. https://doi.org/10.1016/j.brat.2015.12.005 CrossRefGoogle ScholarPubMed
Weiss, P., Shor, R., & Hadas-Lidor, N. (2013). Cultural aspects within caregiver interactions of Ultra-Orthodox Jewish women and their family members with mental illness. American Journal of Orthopsychiatry, 83, 520–527. https://doi.org/10.1111/ajop.12045 CrossRefGoogle ScholarPubMed
Wikler, M. (1986). Pathways to treatment: how Orthodox Jews enter therapy. Social Casework, 67, 113–118. https://doi.org/10.1177/104438948606700207 CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.