(PS9-2) Acceptability and Cultural Considerations of DBT-A for Chinese Mental Health Professionals

Suicide is a major cause of death in China among adolescents (Zhao & Zhang, 2015; Li, 2020), and has increased in rates in youth over the last decade (Zhao et al., 2023). Dialectical Behavior Therapy (DBT) comprehensively treats patients with complex and high-risk behaviors (Linehan et al., 1993), and has been effective in reducing self-harm and suicidal ideation in adolescents (Goldstein, 2023; McCauley et al., 2018; Mehlum et al., 2014). No studies to date have investigated clinical outcomes of applying DBT, developed in the US, to Chinese adolescents, or implementation factors such as acceptability in training Chinese clinicians (Chen et al., 2016; Hodges & Oei, 2007), though there is a strong need for DBT in China. The present research sought to explore cultural considerations in providing a virtual foundational training (by a senior B-Tech trainer) in DBT for Adolescents to a large sample (N = 210) of Chinese mental health professionals living in China. Finding culturally-based principles “compatible with the client’s cultural patterns, meanings, and values” (Bernal et al., 2009, p. 362) is particularly helpful to create validating therapeutic environments for clients, and in training clinicians as well. Increasing awareness of cultural factors in applying DBT to Chinese youth is also important in helping to navigate the stigma associated with seeking therapy for Chinese individuals (Qian et al., 2001; Zane & Mak, 2003). The present mixed-methods study recorded written and spoken responses and questions during Zoom discussions and administered surveys with open-ended questions and Likert-scales regarding reactions to components of DBT to Chinese clinicians in Shanghai receiving training in DBT for Adolescents (DBT-A). Participants’ questions and comments were deidentified, transcribed, pooled, translated to English, and coded for themes regarding cultural dissonance in elements of the treatment. Using the Auerbach & Silverstein (2003) method, coders identified repeating ideas, themes, and finally, theoretical constructs that pertain to cultural factors. Quantitative results include ratings of how relevant and helpful each major component of DBT was to their practice. Twenty-one themes emerged, including apprehension about applying DBT interpersonal effectiveness skills in a collectivist culture, navigating conflicts in parent-teen relationships, and concerns about disrespect towards parents. These findings suggest areas for enriching cultural attunement and responsiveness when training Chinese mental health professionals, as well as implementing the treatment with Chinese youth and their families. Informing culturally attuned applications of DBT to Chinese clinicians and their constituents would serve the needs of CBT clinicians’ communities, promote equity and diversity in CBT practice research, and surmount barriers to treatment and educational access, which promote the Community Engagement and Advocacy categories of ABCT’s call for proposals.