Community Mental Health Journal

, Volume 38, Issue 6, pp 497–504 | Cite as

Brief Report: Adapted Cognitive Behavioral Group Therapy for Depressed Low-Income African American Women

  • Laura P. Kohn
  • Tatia Oden
  • Ricardo F. Muñoz
  • Ayinka Robinson
  • Daria Leavitt


In this study we examine the degree to which a manualized cognitive-behavioral therapy intervention can be adapted to be culturally sensitive in treating depressed low-income African American women with multiple stressors. We describe the adaptations we made to an existing intervention, a group treatment developed for depressed low-income medical patients. We also describe our evaluation of the adapted treatment in which outcomes of African American women treated in the culturally adapted group were compared to African American women treated in the non-adapted group. Following treatment, women in the adapted group exhibited a larger drop in average BDI scores. Implications are discussed in terms of challenges related to the development and evaluation of culturally adapted treatment.

cognitive-behavioral therapy African American depression 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.Google Scholar
  2. Boyd-Franklin, N. (1987). Group therapy for Black women: A therapeutic support model. American Journal of Orthopsychiatry, 57, 394–401.Google Scholar
  3. Boyd-Franklin, N. (1991). Recurrent themes in the treatment of African-American women in group psychotherapy. Women & Therapy, 11, 25–40.Google Scholar
  4. Brown, C., Schulberg, H. C. & Madonia, M. J. (1996). Clinical presentations of major depression by African Americans and whites in primary medical care practice. Journal of Affective Disorders, 41, 181–191.Google Scholar
  5. Ellison, C.G. (1995). Race, religious involvement and depressive symptomatology in a southeastern U.S. community. Social Science & Medicine, 40, 1561–1572.Google Scholar
  6. Greene, B. (1992). Still here: A perspective on psychotherapy with African-American women. In J. C. & H. D. Chrisler (Eds.), New directions in feminist psychology (pp. 13–25). New York: Springer.Google Scholar
  7. Kohn, L. P. & Oden, T. (1997). Group Therapy Manual for African American Women's Group. San Francisco General Hospital, Division of Psychosocial Medicine, San Francisco, CA.Google Scholar
  8. Lewinsohn, P. M., Muñoz, R. F., Youngren, M. A. & Zeiss, A. M. (1986). Control your depression. New York: Prentice-Hall.Google Scholar
  9. Mays, V. M. (1986). Identity development of Black Americans: The role of history and the importance of ethnicity. American Journal of Psychotherapy, 40, 582–593.Google Scholar
  10. McCombs, H. G. (1986). The application of an individual/collective model to the psychology of Black women. Women & Therapy, 5, 2–3.Google Scholar
  11. McNair, L.D. (1996). African American women and behavior therapy: Integrating theory, culture, and clinical practice. Cognitive and Behavioral Practice, 3, 337–349.Google Scholar
  12. Muñoz, R. F. (1997). The San Francisco Depression Prevention Research Project. In G. W. Albee & T. P. Gullota (Eds.), Primary Prevention Works(pp. 380–400). Thousand Oaks, CA: Sage Publications.Google Scholar
  13. Muñoz, R. F. & Miranda, J. (1986). Group therapy manual for cognitive-behavioral treatment of depression. San Francisco General Hospital, Depression Clinic, San Francisco, CA.Google Scholar
  14. Muñoz, R. F., & Ying, Y. W. (1993). The Prevention of Depression: Research and Practice. Baltimore: Johns Hopkins University Press.Google Scholar
  15. Muñoz, R.F., Ying, Y.W., Bernal, G., Pérez-Stable, E.J., Sorensen, J.L., Hargreaves, W.A.,Miranda, J., & Miller, L.S. (1995). Prevention of depression with primary care patients: A randomized controlled trial. American Journal of Community Psychology, 23, 199–222.Google Scholar
  16. Neal, A. M. & Wilson, M. L. (1989). The role of skin color and features in the Black community: Implications for Black women and therapy. Clinical Psychology Review, 9, 323–333.Google Scholar
  17. Neighbors, H. W., Bashur, R., Price, R., Selig, S., Donabedian, A., & Shannon, G. (1992). Ethnic minority mental health service delivery: A review of the literature. Research in Community Mental Health, 7, 55–71.Google Scholar
  18. Nietzel, M. T., Russell, R. L., Hemmings, K. A. & Gretter, M. L. (1987). Clinical significance of psychotherapy for unipolar depression:Ameta-analytic approach to social comparison. Journal of Consulting and Clinical Psychology, 55, 156–161.Google Scholar
  19. Organista, K. C. Muñoz, R. F. & González, G. (1994). Cognitive-Behavioral therapy for depression in low-income and minority medical outpatients: Description of a program and exploratory analyses. Cognitive Therapy and Research, 18, 241–259.Google Scholar
  20. Randall, E. J. (1994). Cultural relativism in cognitive therapy with disadvantaged African American women. Journal of Cognitive Psychotherapy: An International Quarterly, 8, 195–207.Google Scholar
  21. Snowden, L. (1999). African American service use for mental health problems. Journal of Community Psychology, 27, 303–313.Google Scholar
  22. Sue, S. (1988). Psychotherapeutic services for ethnic minorities: Two decades of research findings. American Psychologist, 43, 301–308.Google Scholar
  23. Vega, W. A. & Rumbaut, R. G. (1991). Ethnic minorities and mental health. Annual Review of Sociology, 17, 351–383.Google Scholar

Copyright information

© Human Sciences Press, Inc. 2002

Authors and Affiliations

  • Laura P. Kohn
    • 1
  • Tatia Oden
  • Ricardo F. Muñoz
    • 2
  • Ayinka Robinson
  • Daria Leavitt
    • 3
  1. 1.Department of PsychologyUniversity of MichiganAnn Arbor
  2. 2.University of CaliforniaSan Francisco
  3. 3.Columbia UniversityUSA

Personalised recommendations