title: The methods and outcomes of cultural adaptations of psychological treatments for depressive disorders: a systematic review.
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.
  
  
  METHODS
  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.
authors.affiliation: Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK, and Sangath, India.
authors.forename: N
authors.initials: N
authors.lastname: Chowdhary
authors.affiliation: Institute of Psychiatry, King's College, London, UK, Public Health Foundation of India, and Sangath, India.
authors.forename: A T
authors.initials: AT
authors.lastname: Jotheeswaran
authors.affiliation: London School of Hygiene and Tropical Medicine, UK.
authors.forename: A
authors.initials: A
authors.lastname: Nadkarni
authors.affiliation: Vanderbilt University, Nashville, TN, USA.
authors.forename: S D
authors.initials: SD
authors.lastname: Hollon
authors.affiliation: Faculty of Brain Sciences, University College London Medical School, UK.
authors.forename: M
authors.initials: M
authors.lastname: King
authors.affiliation: London School of Hygiene and Tropical Medicine, UK.
authors.forename: M J D
authors.initials: MJ
authors.lastname: Jordans
authors.affiliation: University of Liverpool, UK.
authors.forename: A
authors.initials: A
authors.lastname: Rahman
authors.affiliation: Teachers College, Columbia University and Columbia College of Physicians and Surgeons, NY, USA.
authors.forename: H
authors.initials: H
authors.lastname: Verdeli
authors.affiliation: University of Bristol, UK.
authors.forename: R
authors.initials: R
authors.lastname: Araya
authors.affiliation: Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK, and Sangath, India.
authors.forename: V
authors.initials: V
authors.lastname: Patel
mesh_terms: D065246:Culturally Competent Care / Q000379:methods* / Q000592:standards; D003866:Depressive Disorder / Q000208:ethnology / Q000628:therapy*; D006801:Humans; D008913:Minority Groups / Q000523:psychology*; D011613:Psychotherapy / Q000379:methods* / Q000592:standards