The nature and efficacy of culturally-adapted psychosocial interventions for schizophrenia: a systematic review and meta-analysis

Abstract

The adaptation process can be described within a framework that serves as a benchmark for development or assessment of future adaptations. Culturally adapted interventions were more efficacious than usual treatment in proportion to the degree of adaptation. There is insufficient evidence to show that adapted interventions are better than non-adapted interventions. Features of context, intervention and design influenced efficacy. Investigating whether adaptation improves efficacy, most importantly amongst ethnic minorities, requires better designed trials with comparisons against unadapted interventions.

Psychosocial Family Interventions for Relatives of People Living with Schizophrenia in the Arab World: Systematic Review

“…The cultural adaptation process of family interventions in the Arab world was consistent with some of the themes found in previous studies including language, content, concepts and illness models, cultural norms and practice, context and delivery (11,13,14). The language of the original manuals was translated into Arabic and the content was modified to fit the cultural and religious norms and values.…”

“…Recently, researchers have shown an increased interest in culturally adapting family interventions to different cultures to improve the acceptability and effectiveness of the treatment (7,(13)(14)(15)(16)(17)(18). These studies have shown that there is optimal benefit when interventions are tailored for a specific culture.…”

How community therapists describe adapting evidence‐based practices in sessions for youth: Augmenting to improve fit and reach

“…However, just as adaptations have the potential to improve the impact and durability of treatment, it is also plausible that adaptations may compromise the delivery of essential treatment mechanisms (Drake et al, 2001). Cultural adaptations research provides one such example of this tension; meta‐analyses reflect mixed evidence on the necessity and impact of cultural adaptations, with some citing adaptations as beneficial for clinical outcomes and implementation efforts (e.g., Benish, Quintana, & Wampold, 2011; Degnan et al, 2018; Hall, Ibaraki, Huang, Marti, & Stice, 2016; Van Mourik, Crone, De Wolff, & Reis, 2017), and others finding no added utility in modifying protocols (e.g., Huey & Polo, 2008; Huey & Polo, 2017; Thomas, Abell, Webb, Avdagic, & Zimmer‐Gembeck, 2017). Overall, there is continued debate on whether fidelity to manualized therapies should be prioritized over flexibility and local adaptations to the intervention for particular clients or contexts (Hamilton, Kendall, Gosch, Furr, & Sood, 2008; Owen & Hilsenroth, 2014).…”

Trainee editorial: psychiatry should be taught from day one in medical school‡

“…Ethnic differences might have a great impact on received diagnoses [8]. Considering culture and adapting intervention accordingly improves response [9].…”