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Meta-Analysis
. 2014 Apr;44(6):1131-46.
doi: 10.1017/S0033291713001785. Epub 2013 Jul 19.

The methods and outcomes of cultural adaptations of psychological treatments for depressive disorders: a systematic review

N Chowdhary  1 , A T Jotheeswaran  2 , A Nadkarni  3 , S D Hollon  4 , M King  5 , M J D Jordans  3 , A Rahman  6 , H Verdeli  7 , R Araya  8 , V Patel  1
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Free PMC article
Meta-Analysis

The methods and outcomes of cultural adaptations of psychological treatments for depressive disorders: a systematic review

N Chowdhary et al. Psychol Med. 2014 Apr.
Free PMC article

Abstract

Background: Cultural adaptations of evidence-based psychological treatments (PTs) are important to enhance their universal applicability. The aim of this study was to review systematically the literature on adaptations of PTs for depressive disorders for ethnic minorities in Western countries and for any population in non-Western countries to describe the process, extent and nature of the adaptations and the effectiveness of the adapted treatments.

Method: Controlled trials were identified using database searches, key informants, previous reviews and reference lists. Data on the process and details of the adaptations were analyzed using qualitative methods and meta-analysis was used to assess treatment effectiveness.

Results: Twenty studies were included in this review, of which 16 were included in the meta-analysis. The process of adaptation was reported in two-thirds of the studies. Most adaptations were found in the dimensions of language, context and therapist delivering the treatment. The meta-analysis revealed a statistically significant benefit in favor of the adapted treatment [standardized mean difference (SMD) -0.72, 95% confidence interval (CI) -0.94 to -0.49].

Conclusions: Cultural adaptations of PTs follow a systematic procedure and lead primarily to adaptations in the implementation of the treatments rather than their content. Such PTs are effective in the treatment of depressive disorders in populations other than those for whom they were originally developed.

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Figures

Fig. 1.
Fig. 1.
Flow chart of studies included in the review. PT, Psychological treatment; DD, depressive disorder.
Fig. 2.
Fig. 2.
Effect of psychological interventions compared to usual care/no treatment control group. Outcome: depression (higher score indicates greater severity). CI, confidence interval; df, degrees of freedom; s.d., standard deviation.
See this image and copyright information in PMC

Comment in

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