A culturally adapted family intervention for rural Pacific Island veterans with PTSD.

Abstract

To pilot Koa, rural Pacific Island dyads (28 veterans and 28 family members) participated via video teleconference and completed pre- and post- intervention measures. Outcome data indicated that participants perceived the intervention to be highly acceptable, useful, and relevant. Relationship quality scores substantially improved postintervention as measured by the Dyadic Relationship Scale (95% CI [-10.97, -1.84], t(22) = -2.9, p = .008, d = -0.53 for veterans; 95% CI [-11.06, -2.47], t(21) = -3.28, p = .004, d = -0.68 for family members). Family caregiving burden also improved significantly. The positive results of this investigation support the development of culturally adapted mental health interventions for culturally distinct subgroups of veterans and their families. (PsycINFO Database Record

Treating posttraumatic stress disorder across cultures: A systematic review of cultural adaptations of trauma‐focused cognitive behavioral therapies

“…Community stakeholders were described as involved in the adaptation process in eight papers (Bigfoot & Schmidt, ; Damra et al, ; Kaysen et al, ; O'Donnell et al, ; Rodriguez, ; Schulz et al, ; Valentine et al, ; Whealin et al, ). These steps included the use of focus groups, qualitative interviews, and translation processes before recommending adaptations to the identified intervention.…”

“…Regarding consultation with stakeholders, the stakeholders mentioned as involved in the adaptation process were most commonly local therapists delivering the treatment (Asukai et al, ; McMullen et al, ; Murray et al, ; O'Callaghan et al, ; Rodriguez, ; Schulz et al, ; Valentine et al, ), or other counsellors from the community (e.g., professionals from service organizations; tribal leaders, school teachers; Bigfoot & Schmidt, ; Damra et al, ; Goodkind et al, ; Kaysen et al, ; O'Donnell et al, ; Whealin et al, ). In four studies, the adaptation process included consultation with consumers of the treatment (e.g.…”

“…Six studies (Damra et al, ; Kaysen et al, ; Murray et al, ; O'Donnell et al, ; Valentine et al, ; Whealin et al, ) described iterative processes of adapting the therapy that included manual translation, meetings with key stakeholders, training of local therapists, and pilot testing of the adapted interventions followed by evaluation by the treatment stakeholders. Schulz et al () described a process with fewer steps that involved translation of the materials and a feasibility study.…”

“…For example, some researchers made changes in the conceptualization of trauma's effects (e.g., added spiritual approach to trauma conceptualization; Bigfoot & Schmidt, ; Goodkind et al, ), and added new content to sessions (Bigfoot & Schmidt, ; Goodkind et al, ; Kaysen et al, ; Lane et al, ; Whealin et al, ). Other researchers described adding additional sessions with family members (Damra et al, ; Goodkind et al, ; McMullen et al, ), and adaptations related to the therapist, such as greater therapist self‐disclosure (Whealin et al, ), increased visits with participants (O'Callaghan et al, ), and changes to the process of supervision and supervisor training (Kaysen et al, ). Other adaptations included adding techniques or interventions that were observably in line with the culture (e.g., relaxation techniques; Schulz et al, ).…”

“…Length of follow‐up time and other characteristics of research methods (e.g., sample size, blinded assessors, assessment measure quality) also varied greatly. Overall, improvements favouring the adapted intervention were noted in 14 of the studies (Asukai et al, ; Bass et al, ; Damra et al, ; Goodkind et al, ; Kaysen et al, ; Lane et al, ; McMullen et al, ; Murray et al, ; O'Callaghan et al, ; O'Donnell et al, ; Schulz et al, ; Valentine et al, ; Wang et al, ; Whealin et al, ) and the efficacy of treatment did not seem to vary based on the stage model or process used. In one study (Rodriguez, ), efficacy could not adequately be tested because of problems with participant recruitment and retainment.…”