In alignment with SAMHIN’s mission to foster open dialogue around mental health within the South Asian community and spotlight the voices driving this important work we invited Ananya Dhoundiyal to tell us about Culturally Adapted Cognitive Behavior Therapy for South Asians. If you missed her previous insightful post, you can read Yoga Roadmap for Anxiety and Depression.
Most of us have heard of cognitive behavior therapy being the “gold standard” for treating anxiety and depression, and therapists use it around the world. But cognitive behavior therapy wasn’t originally designed with everyone in mind. That’s why researchers at CAMH in Canada developed culturally adapted CBT (CA‑CBT) specifically for the South Asian community. It keeps the core logic of how our thoughts, feelings, and behaviors impact one another but changes the delivery so it actually makes sense within the context of a South Asian family.
Given my background of working as a therapist across India, Canada, and the U.S, I didn’t know culturally adapted CBT existed until I joined the project myself. I initially thought I had a handle on cross-cultural care, given that I was a first-generation immigrant in Canada. But starting on the team in Canada as a therapist and then becoming a master trainer for teaching this module completely shifted my perspective, making me realize just how deeply our culture dictates how we feel stress, talk about our emotions, and seek help.
One major shift in CA‑CBT is moving away from medical jargon and focusing on what’s happening in the body. In our community, emotional pain often shows up as physical symptoms. People describe anxiety as a knot in the stomach, persistent headaches, a heavy feeling in the chest, or total exhaustion. By addressing these “somatic” symptoms first, clients feel like their therapist truly hears them, which builds a huge amount of trust early on.
Then there’s the spiritual side of things. CA-CBT doesn’t ignore the fact that many of us use alternative healing modalities like ayurveda, yoga, traditional healers, or religious rituals. Instead of dismissing them, we look at how they’re actually working for you. Does your spiritual practice bring you peace, or is it accidentally fueling more guilt and fear? It’s about honoring your whole world, not just the parts that fit into a pre-defined framework.
In CA‑CBT family and the extended family is the heart of the story. We talk about recurrent themes of duty, the pressure to keep everyone happy, birth order, and that heavy weight of “log kya kahenge” (what will people say). Clients don’t have to spend half the session explaining why setting a boundary feels almost like a betrayal. The cultural circle is so tightly knit that even I, as a professional, sometimes have to check myself to make sure I’m not inadvertently part of that log kya kahenge pressure.
CA-CBT also weaves in the stress of migration. Whether you’re the one who moved or the child or grandchild of someone who did, that loss of community and the struggle to rebuild an identity is definitely real. CA‑CBT names that experience instead of treating it like a footnote. For many, it’s the first time they’ve been allowed to grieve the emotional cost of moving between worlds, and for many others it’s their first experience of going into a therapy office.
The therapy even uses metaphors and stories that actually land. Instead of explanations, a therapist might describe the mind and interventions using stories that click instantly because they come from a familiar place and help contextualize concepts.
Since moving to Virginia and continuing my work in the U.S, I see how much we still need this type of therapy. Most people are surprised to hear that CA‑CBT is even an option. It’s not a brand new therapy. It’s CBT delivered with warmth and cultural grounding. As more of us start using these tools, more South Asians will finally feel like they actually belong in the therapy room.
If you are a therapist or a community member interested in learning more, you can access the full CA-CBT manual, final research report, and training videos from CAMH: CAMH CA-CBT resources and CAMH CA-CBT training videos.
By Ananya Dhoundiyal, LMSW, psychotherapist in private practice in Virginia and dedicated SAMHIN volunteer. Ananya brings clinical expertise from her international practice across India, Canada, and the United States. She contributed to the pilot testing of the culturally adapted-cognitive behavioral therapy (CA-CBT) module in collaboration with the Centre of Addiction and Mental Health (CAMH) in Canada as a therapist and later as a master trainer.
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Thank you for sharing this. I am a first generation Indian American, 49 year old daughter of Indian immigrants who came to the US in the 70s. I was raised as an Indian American kid in the NJ of the 80s and 90s. My 2 nephews are the second generation of my family here. I am actually very assimilated and Americanized and well integrated into American society. America is so deeply home in every way. However, in spite of all that, I am still dealing with an internal cultural duality. The Indian cultural condition remains very strongly even if you no longer, like me, have no interaction with the Indian community and culture. I discovered this after doing years of therapy addressing my bicultural identity with a therapist of color who is also a child of Ecuadorian immigrants.
Thanks for sharing these CBT resources adapted for South Asians. So very needed in our therapist communities.
Hi Laavanya,
I’m so grateful you shared this. That duality is so real and so human. It’s interesting how culture isn’t static, not something outside of us and we get to collectively shape it together as we grow. I’m really glad you had the chance to explore it in therapy. Hope you continue to follow your unique path, and trust that it’s quietly shaping the collective too.
Hi Aparna,
Thanks for the comment. Glad it helps.
Thank you for this thoughtful article. One thing I’ve come to appreciate is that healing doesn’t happen in a vacuum. Our culture, family, beliefs, and life experiences all shape how we see ourselves and the world. Knowing that CBT has been adapted to reflect the South Asian experience gives me hope that more people in our community will feel understood and be willing to reach out for support. Thank you for helping reduce the stigma around mental health.
Thank you so much for sharing. I’m curious what kinds of workshops or community spaces you feel would make it easier for South Asians to talk about mental health. Would love to hear what feels most needed or meaningful.