(PS4-61) Promoting inclusive therapies for Asian American youth: Clinicians’ approaches to cultural tailoring of trauma-focused treatments

Abstract Text: Trauma exposure is disproportionately high in U.S. communities of color, including in Asian American communities (McLaughlin et al., 2019). Asian Americans also demonstrate the lowest rates of mental health service utilization relative to other racially minoritized groups (Cook et al., 2017). Cultural tailoring of interventions is one strategy to improve engagement in mental health services by addressing unique factors that shape help-seeking behaviors and treatment adherence (Arora et al., 2021). Incorporating culturally relevant values into treatment were found to strengthen trust in the therapeutic process and relationship (Asnaani & Hofmann, 2012). However, research on culturally responsive modifications to trauma-focused treatments for Asian American youth is limited. Thus, the aim of this qualitative study was to leverage practice-based evidence by exploring providers’ current strategies for cultural tailoring of trauma-focused care for Asian American youth. Participants were licensed mental health clinicians in the U.S. currently serving Asian American youth (N = 10). Participants were recruited from November 2023 - September 2024 via emails containing study flyers to organizations and networks that provide mental health services to Asian American youth with trauma histories. Participants completed a 45-minute, semi-structured interview via Zoom facilitated by trained research assistants. Interviews included questions about clinicians’ current approaches to trauma-focused care and strategies for cultural tailoring. Data analysis followed an inductive thematic analysis approach, with themes directly derived from interview transcripts (Braun & Clarke, 2006). Interview transcripts were reviewed independently by each member of a 3-person coding team to identify potential codes. The team met weekly to synthesize themes into a codebook, discuss discrepancies, and refine codes which continued until saturation was reached (i.e., no new themes emerged). The finalized codebook was applied by all coders to a subset of data (20%; n = 2) to assess inter-rater reliability. The remaining transcripts were then each double-coded by two team members using NVivo 14. Findings revealed the ways clinicians tailor their trauma-focused care to meet the needs of Asian American youth. Subthemes of cultural tailoring practices included 1) additional psychoeducation to combat mental health stigma and literacy, 2) incorporation of culturally-relevant strengths and sources of healing (e.g., somatic practices, nonverbal demonstration of concepts) into treatment, 3) strategies to build trust during initial treatment engagement (e.g., self-disclosure of shared experience, addressing power imbalance), and 4) discussion of generational differences in attitudes towards mental health care. Exemplar quotes across these themes will be provided. In the absence of empirically supported cultural tailoring guidelines, this study synthesizes strategies that clinicians employ in real-world settings to deliver culturally-responsive trauma-focused care for Asian American youth. In line with the conference theme, these findings hold implications for informing the development of inclusive therapies for Asian American youth.