Development of a culturally adaptable internet-based cognitive behavioral therapy for Japanese women with bulimia nervosa

Sayo Hamatani; Kazuki Matsumoto; Tomoaki Ishibashi; Ryunosuke Shibukawa; Yuki Honda; Hirotaka Kosaka; Yoshifumi Mizuno; Gerhard Andersson

doi:10.3389/fpsyt.2022.942936

Development of a culturally adaptable internet-based cognitive behavioral therapy for Japanese women with bulimia nervosa

Front Psychiatry. 2022 Aug 23:13:942936. doi: 10.3389/fpsyt.2022.942936. eCollection 2022.

Authors

Sayo Hamatani^{1

2

3

4}, Kazuki Matsumoto^{4

5}, Tomoaki Ishibashi⁶, Ryunosuke Shibukawa⁶, Yuki Honda⁶, Hirotaka Kosaka^{1

2

3

6}, Yoshifumi Mizuno^{1

2

3}, Gerhard Andersson^{7

8}

Affiliations

¹ Research Center for Child Mental Development, University of Fukui, Fukui, Japan.
² Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan.
³ Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan.
⁴ Research Center for Child Mental Development, Chiba University, Chiba, Japan.
⁵ Division of Clinical Psychology, Kagoshima University Hospital, Kagoshima, Japan.
⁶ Department of Neuropsychiatry, University of Fukui, Fukui, Japan.
⁷ Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
⁸ Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.

Abstract

Background: The process of cultural adaptation of internet-based cognitive behavioral therapy (ICBT) programs for bulimia nervosa (BN) have rarely been reported despite the potential influence of cultural adaptation of psychosocial interventions on therapeutic response.

Aim: This study aimed to illustrate development process of an ICBT program for Japanese women with bulimia nervosa (BN).

Methods: A mixed methods approach was used to assess cultural adaptation of the prototype of an original ICBT program by using the Cultural Relevance Questionnaire (CRQ). Five women with BN and seven clinicians were interviewed using the CRQ.

Results: Quantitative analyses were conducted to assess cultural adaptation of the prototype of the program and participants rated cultural adaptation as high. A qualitative analysis of the mixed method supported the culturally sensitive changes implemented.

Conclusions: The results of this study show that a series of processes can make ICBT programs more culturally adapted.

Keywords: bulimia nervosa (BN); cultural adaptation; cultural sensitivity; ecological validity; internet-based cognitive behavioral therapy (ICBT).