Clinical Round Table 12 - When Translation Is Not Enough: Diversity-related Communication Barriers and Adaptations in CBT for Culturally Diverse and Neurodivergent Individuals

When communication challenges arise in CBT with diverse patients, they are commonly conceptualized as problems of language translation or linguistic complexity, resulting in clinical responses that are typically limited to translation or simplification of therapeutic language. However, clinicians frequently encounter persistent barriers to engagement, learning, and therapeutic change that cannot be explained by language alone. These barriers reflect deeper mismatches between standard CBT models and the cultural and neurodevelopmental contexts in which treatment is delivered.

This clinical roundtable brings together clinicians with expertise working with distinct populations: South Asian individuals from Pakistani and Indian backgrounds, including Urdu and Hindi-speaking communities; Mandarin-speaking and Asian American patients; autistic and ADHD identifying individuals; and Latine-identifying individuals . Panelists will draw on clinical experience and the existing research literature to illustrate communication and learning barriers encountered in CBT across these groups, including real-world clinical examples. Emphasis will be placed on how treatment adaptations can be thoughtfully implemented while maintaining fidelity to core CBT principles and evidence-based practice.

Through a structured, facilitated discussion, panelists will respond to shared prompts and case-based scenarios, allowing for comparison across groups and identification of both common and group-specific barriers. The discussion will also focus on practical strategies for adapting CBT interventions, including modifications to conceptual frameworks, therapeutic goals, and modes of skill acquisition. Time will be reserved for questions from audience members, allowing attendees to engage with panelists around clinical challenges in their own practice and to consider how diversity-related adaptations can be conceptualized, tested, and refined within routine CBT delivery.