Effects of Mental Health Interventions With Asian Americans: A Review and Meta-Analysis

Objective: Evidence demonstrating treatment efficacy for ethnic minorities has grown in recent years; however, Asian Americans (i.e., of East Asian or Southeast Asian heritage) are mostly excluded from recent reviews. In this review we (a) synthesize the literature on mental health treatment effects for Asian Americans and (b) evaluate support for competing theoretical perspectives on cultural tailoring. Method: A literature search supplemented with other search strategies identified 21 randomized trials of mental health interventions for Asian Americans (n = 6,377 total participants). The meta-analysis was based on random-effects models. Results: Overall, results show that posttreatment effects were relatively large and significant (d = .75, SE = .14, p = .000). However, there was substantial heterogeneity across studies (ES range = -.04 to 2.61), with moderator analyses indicating that effects differed significantly by target problem, diagnostic status, and comparison group. Also, specificity of cultural tailoring was significantly associated with treatment outcomes, with treatments tailored specifically for Asian subgroups (e.g., Chinese Americans) showing the largest effects (d = 1.10), and those with no cultural tailoring or non-Asian tailoring (d = .25) showing the smallest effects. Conclusions: Findings suggest that mental health treatments are efficacious for Asian Americans and that cultural tailoring can enhance treatment outcomes. In general, these findings lend support to the cultural responsiveness hypothesis, although caveats are noted. Implications for psychotherapy research with Asian Americans are discussed, as well as methodological and conceptual challenges.