Effectiveness of an intercultural module added to the treatment guidelines for Moroccan and Turkish patients with depressive and anxiety disorders.
BACKGROUND
Since the sixties of the last century, many people from Morocco and Turkey have migrated into the Netherlands. In the last decade, Moroccan and Turkish patients have found their way to organizations for mental health care. However, they often drop out of treatment. Problems in the communication with therapists and different expectations regarding treatment seem to be causal factors for the early drop-out of therapy. In the Netherlands as in other countries courses have been developed for training cultural competence of therapists. Yet, up to now, the effectiveness of increased cultural competence of therapists in reducing drop-out of treatment has not been studied.


METHODS
A randomized clinical trial was started in January 2010. Moroccan and Turkish adult patients who are referred to our outpatient clinics for mood and anxiety disorders are randomly assigned to mental health workers who are trained in a cultural module and to those who are not. The therapists have been trained in the Cultural Formulation and in techniques bridging the (cultural) gap between them and their Moroccan and Turkish patients. The target number of participants is 150 patients, 75 for each group. Drop-out of treatment is the primary outcome measure. Secondary outcome measures are no-show and patients' perspective of care.


CONCLUSIONS
The study will give an answer to the question whether increasing cultural competence of therapists reduces drop-out of treatment in Moroccan and Turkish outpatients with depressive and anxiety disorders.
Research Department, GGZ inGeest, Amsterdam, The Netherlands. a.vanloon@ggzingeest.nl
Annelies
A
van Loon
Digna J F
DJ
van Schaik
Jack J
JJ
Dekker
Aartjan T F
AT
Beekman
D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000208:ethnology / Q000628:therapy*; D001294:Attitude to Health; D003144:Communication Barriers; D054521:Cultural Competency / Q000193:education; D003866:Depressive Disorder / Q000208:ethnology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009018:Morocco / Q000208:ethnology; D009426:Netherlands / Q000453:epidemiology; D017063:Outcome Assessment, Health Care / Q000379:methods; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D011613:Psychotherapy / Q000193:education / Q000379:methods; D014171:Transients and Migrants / Q000523:psychology*; D016896:Treatment Outcome; D014421:Turkey / Q000208:ethnology
Psychol Med. 1996 May;26(3):477-86
8733206
Soc Psychiatry Psychiatr Epidemiol. 2009 Mar;44(3):208-16
18787746
J Affect Disord. 2007 Jan;97(1-3):229-39
16901547
J Psychother Pract Res. 1996 Summer;5(3):260-71
22700294
J Consult Clin Psychol. 1988 Dec;56(6):893-7
3204199
Acad Med. 2017 Oct;92(10):1406
28952997
BMJ. 1997 Aug 23;315(7106):473-6
9284670
J Psychiatr Res. 1994 Jan-Feb;28(1):57-84
8064641
J Clin Epidemiol. 2003 Jun;56(6):507-14
12873644
J Trauma Stress. 2004 Oct;17(5):429-33
15633922
BMC Health Serv Res. 2007 Jan 31;7:15
17266765
Br J Psychiatry. 1991 Nov;159:645-53, 658
1756340
Ann Intern Med. 2001 May 1;134(9 Pt  2):911-7
11346328
Psychotherapy (Chic). 2006 Winter;43(4):531-48
22122142
Psychiatr Serv. 2010 Jul;61(7):690-7
20592004
Soc Psychiatry Psychiatr Epidemiol. 2008 Nov;43(11):905-12
18587679
J Health Soc Behav. 1978 Mar;19(1):2-21
649936
Gen Hosp Psychiatry. 2006 Jan-Feb;28(1):27-36
16377362
Cult Med Psychiatry. 1996 Jun;20(2):133-44
8853962
Soc Sci Med. 1992 Oct;35(8):1027-35
1411697
Soc Psychiatry Psychiatr Epidemiol. 2000 Sep;35(9):427-35
11089671