AGR – 4 Integrating Cultural Identity into Cognitive Remediation: a Case Study of a Chinese American Medical Student Recovering from Right-Sided Frontal Astrocytoma through Culturally Responsive, Bilingual, CBT-Informed Intervention

Abstract Objective This case study describes the integration of culturally informed treatment into cognitive remediation for a 29-year-old Chinese American first-year medical student following surgery, radiation, and chemotherapy for a right-sided frontal astrocytoma (IDH1-mutant, grade 4, MGMT methylated). Though neuropsychological testing showed generally intact functioning, the patient reported mild anxiety, depression, sleep disturbances, and diminished attention, slowed processing speed, and heightened concern about processing visually mediated information including academic materials. Through culturally informed questioning, the clinician uncovered culturally rooted expectations for performance, beliefs and behaviors regarding mental health as well as modified strategies to facilitate mitigation of these elements. Method Seven weekly one-hour sessions focused on attention, executive functioning, and visual-to-verbal conversion, using materials aligned with her medical curriculum. Sessions were conducted in English and Mandarin to increase linguistic and cultural comfort. Given her parents’ discouragement of psychotherapy—reflecting intergenerational stigma and cultural emphasis on self-reliance common in some Asian cultures—CBT-informed strategies were incorporated into cognitive remediation. Interventions included emotional validation and cognitive reframing of perceived cognitive decline. Results The patient reported improved confidence, reduced distress about her cognitive functioning, and increased ability to manage academic and professional demands. She re-engaged in meaningful activities such as reading and tutoring and ultimately decided to return to medical school. Conclusion This case demonstrates the importance of culturally responsive neuropsychological care for Asian American patients. Addressing intergenerational beliefs, cultural identity, and mental health stigma through integrated therapeutic and cognitive approaches can foster resilience and support recovery for individuals navigating complex intersections of illness, culture, and emotional well-being.