Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)




Although some researchers have suggested that cognitive behavioral therapy (CBT) might be an effective treatment paradigm for minority clients, there is little empirical evidence to support this claim. In addition, few studies have explored the cross-cultural expression of the maladaptive cognitions that CBT targets for change in the treatment of major depressive disorder. The purpose of the present study was twofold: (a) to compare the applicability of CBT approaches and assumptions in Caucasians and American Indians, and (b) to evaluate whether depressotypic cognitions found in the literature related to CBT are equally prevalent in both groups. In study one, an applicability scale for CBT (Cognitive Behavioral Applicability Scale; CBT-AS) was constructed to explore the first aim of the study. The standardization sample for the CBT-AS was composed of 222 undergraduates from the University of North Dakota. The extracted factor structure and reliability data of the CBT-AS provide preliminary evidence that the instrument is a conceptually meaningful and psychometrically sound measure. Three factor scales were derived: focused in-session behavior, active stance, and structured therapeutic relationship. In study two, the generalizability of depressotypic cognitions and CBT applicability between American Indians and Caucasians were compared. American Indian participants (n = 41) were recruited from the Time-Out Wacipi Pow-Wow, whereas Caucasian participants (r. = 41) matched for age and gender were recruited from a community blues festival. Consistent with expectations, a discriminant analysis procedure revealed significant differences between the two groups in terms of perceived CBT applicability. Caucasian participants rated a stronger preference for CBT’s focused in-session behavior and structured therapeutic relationship than the American Indian participants. Both groups rated the active stance ./'•.I %! j . ft domain of CBT as mutually acceptable. In contrast, no significant differences were found between the groups in-terms .of depressotypic cognitions. Based upon the American Indians’ preferences found in this study as well as the treatment literature, several modifications to CBT were proposed for future investigation.