Development and Pilot Testing of a Combined SMART and Tai Chi Intervention for Asian Americans with Depression and Somatic Symptoms

Abstract Asian Americans (AAs) have a distinct pattern of underutilization of mental health services, characterized by delayed onset of treatment and higher attrition rates. Many depressed AAs experience distressing somatic symptoms and focus on these symptoms more than on emotional symptoms. Depressed

patients with somatic distresses have been found to have approximately twice the outpatient and inpatient medical care utilization and twice the annual medical care costs than non-somatizing patients. Yet, there is no effective treatment for patients with co-occurring depression and distressing somatic symptoms. According to

embodied cognition frameworks, the mind influences the body and vice versa. Emotions impact somatic sensations, and physical movements and shapes also impact emotions, such that integrating emotion-focused “top-down” mind-body interventions with body-focused “bottom-up” mind-body interventions may optimize the

effectiveness of existing treatments. In this study, we leverage the embodied cognition framework to integrate the Stress Management and Resiliency Training (SMART), a cognitive and emotion-focused, sedentary intervention, with Qigong/Tai Chi (QTC), a somatic-focused, mind-body movement intervention, to develop

SMART-QTC, a holistic treatment for AAs with depression and distressing somatic symptoms. Guided by the ORBIT model for developing behavioral treatments, we propose to develop and pilot test SMART-QTC intervention for AAs with co-occurring major depressive disorder (MDD) and distressing somatic symptoms by:

(1) recruiting AAs patients with co-occurring MDD and somatic symptoms, and recruiting a stakeholder advisory board, to identify needs, preferences, and key intervention components, (2) develop an integrated SMART-QTC treatment manual, and (3) test feasibility and acceptability of the intervention in a pilot

randomized trial (RCT). The proposed project will provide new scientific knowledge to develop a future efficacy trial of SMART-QTC for AAs with co-occurring MDD and distressing somatic symptoms, which will inform future research on the development of combined psychological and physical movement interventions for other

culturally diverse populations and conditions.