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

Chowdhary, Neerja; Jotheeswaran, AT; Nadkarni, Abhijit; Hollon, Steven D.; King, M. Bruce; Jordans, Mark J. D.; Rahman, A. H. Abdel; Verdeli, Helena; Araya, Ricardo; Patel, Vinesh

doi:10.1017/s0033291713001785

Cited by 253 publications

(237 citation statements)

References 52 publications

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“…By conducting a cultural adaptation of the intervention, especially prior to its implementation, we have tried to ensure that depressed Indonesians will benefit, because culturally adapted treatments demonstrate enhanced effectiveness, according to the evidence provided by research with other populations (Chowdhary et al, 2014). The hope is that the availability of this culturally adapted internetbased intervention will increase access to mental health services for those suffering from depression in Indonesia, given the number of internet users is predicted to increase to 120 million people (50% of the population) by 2018 (Noviandari, 2014).…”

Section: Resultsmentioning

confidence: 99%

“…A study in India ) developed a behavioral activation treatment that emphasized problem solving and the activation of social networks that were culturally sensitive to the needs of the local population. They devised a systematic adaptation method based upon findings from their systematic review (Chowdhary et al, 2014). For example, during the treatment, they used more general terms that align with local health beliefs, because most patients did not regard their symptoms as related to "mental disorder" .…”

Section: Introductionmentioning

confidence: 99%

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Guided Act and Feel Indonesia – Internet-based Behavioral Activation Intervention for Depression in Indonesia: A Systematic Cultural Adaptation

et al. 2018

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Depression is one of the leading causes of the global disease burden, affecting millions of people worldwide. The availability of mental health treatment, however, remains very limited in many low-middle income countries, including Indonesia. Internet-based interventions are known to have the potential to deliver mental health treatment economically and appropriately according to numerous studies conducted in high-income countries. In the current study, we describe a systematic cultural adaptation of an internet-based behavioral activation intervention for depression in Indonesia, named Guided Act and Feel Indonesia. During the adaptation, relevant stakeholders were involved, including licensed clinical psychologists, mental health communities, lay counselors, and patients. The adaptation used the formative method for adapting psychotherapy (FMAP) to adapt eight important cultural elements (language, persons, metaphors, content, concepts, goals, methods, and context). The intervention was adapted from the original Dutch version called Doe en Voel, consisting of 8 structured modules that are offered in a secure online environment. The adapted version is being delivered during an ongoing randomized controlled trial with non-face-to-face support from lay counselors who work under the supervision of licensed clinical psychologists. The challenges that were faced during the cultural adaptation are discussed.Guided Act and Feel Indonesia-Intervensi Aktivasi Perilaku Berbasis Internet untuk Depresi di Indonesia: Adaptasi Budaya yang Sistematis AbstrakDepresi adalah salah satu penyebab utama beban penyakit global yang mempengaruhi jutaan orang di seluruh dunia. Namun, ketersediaan perawatan kesehatan mental masih sangat terbatas di negara-negara yang berpenghasilan rendah termasuk Indonesia. Kemudian, intervensi depresi berbasis internet telah diketahui memiliki potensi untuk memberikan perawatan kesehatan mental secara ekonomis dan tepat sesuai dengan berbagai penelitian yang dilakukan di negaranegara berpenghasilan tinggi. Pada studi ini, peneliti mendeskripsikan adaptasi budaya secara sistematis dari intervensi aktivasi perilaku berbasis internet untuk depresi di Indonesia, bernama Guided Act and Feel Indonesia. Selama proses adaptasi, para pemangku kepentingan yang relevan dilibatkan, termasuk psikolog klinis berlisensi, komunitas kesehatan mental, konselor, dan pasien. Adaptasi menggunakan metode formatif untuk adaptasi psikoterapi (FMAP) untuk mengadaptasi delapan elemen adaptasi budaya penting (bahasa, orang, metafora, konten, konsep, tujuan, metode, dan konteks). Intervensi ini diadaptasi dari versi asli Belanda yakni Doe en Voel, yang terdiri dari 8 modul terstruktur yang ditawarkan pada lingkungan online yang aman. Versi yang disesuaikan kemudian disampaikan selama percobaan terkontrol secara acak yang berlangsung tanpa tatap muka dari konselor yang bekerja di bawah pengawasan psikolog klinis berlisensi. Tantangan yang dihadapi selama adaptasi budaya juga dibahas dalam penelitian ini.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Guided Act and Feel Indonesia – Internet-based Behavioral Activation Intervention for Depression in Indonesia: A Systematic Cultural Adaptation

et al. 2018

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“…Such adaptations can be informed by rapid qualitative research by using established methodologies. 24,25 Nevertheless, the innovation is not without some startup and running costs, and policy makers would need to factor these into their planning. Small demonstration projects, such as the one described here, could help build capacity and confidence in implementers and policy makers, before scale-up.…”

Section: Business Innovation: the Social Franchise Modelmentioning

confidence: 99%

Model for Service Delivery for Developmental Disorders in Low-Income Countries

et al. 2015

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As in many low-income countries, the treatment gap for developmental disorders in rural Pakistan is near 100%. We integrated social, technological, and business innovations to develop and pilot a potentially sustainable service for children with developmental disorders in 1 rural area. Families with developmental disorders were identified through a mobile phone–based interactive voice response system, and organized into “Family Networks.” “Champion” family volunteers were trained in evidence-based interventions. An Avatar-assisted Cascade Training and information system was developed to assist with training, implementation, monitoring, and supervision. In a population of ∼30 000, we successfully established 1 self-sustaining Family Network consisting of 10 trained champion family volunteers working under supervision of specialists, providing intervention to 70 families of children with developmental disorders. Each champion was responsible for training and providing ongoing support to 5 to 7 families from his or her village, and the families supported each other in management of their children. A pre-post evaluation of the program indicated that there was significant improvement in disability and socioemotional difficulties in the child, reduction in stigmatizing experiences, and greater family empowerment to seek services and community resources for the child. There was no change in caregivers’ well-being. To replicate this service more widely, a social franchise model has been developed whereby the integrated intervention will be “boxed” up and passed on to others to replicate with appropriate support. Such integrated social, technological, and business innovations have the potential to be applied to other areas of health in low-income countries.

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“…In the field of mental health, there is robust evidence that lay counselors (a person without professional qualification in mental health care) can be trained to deliver PT effectively for people with depressive and anxiety disorders in low‐ and middle‐income countries (LMIC) (van Ginneken et al., 2013). There is also evidence demonstrating that PT developed in Western cultural contexts retain their effectiveness in different cultural contexts, when adapted following a systematic methodology (Chowdhary et al., 2013). A key Grand Challenge in Global Mental Health is to design a methodology for the development and evaluation of PT by lay counselors (Collins et al., 2011).…”

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confidence: 99%

The Systematic Development and Pilot Randomized Evaluation of Counselling for Alcohol Problems, a Lay Counselor‐Delivered Psychological Treatment for Harmful Drinking in Primary Care in India: The PREMIUM Study

Nadkarni

Velleman

Dabholkar³

et al. 2015

Alcohol Clin Exp Res

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BackgroundDespite harmful drinking causing a significant burden on global health, there is a large treatment gap, especially in low‐ and middle‐income countries. A major barrier to care is the lack of adequately skilled human resources to deliver contextually appropriate treatments. This paper describes the systematic process used to develop Counselling for Alcohol Problems (CAP), a brief psychological treatment (PT) for delivery by lay counselors in routine primary care settings to men with harmful drinking in India.MethodsCAP was developed using a methodology involving 3 sequential steps: (i) identifying potential treatment strategies; (ii) developing a theoretical framework for the treatment; and (iii) evaluating the acceptability and feasibility of the treatment.ResultsCAP is a 3‐phase treatment delivered over 1 to 4 sessions based on a motivational interviewing (MI) stance and involves the following strategies: assessment and personalized feedback, family engagement, drink refusal skills, skills to address drinking urges, problem‐solving skills and handling difficult emotions, and relapse prevention and management. Data from a case series were used to inform several adaptations to enhance the acceptability of CAP to the recipients and feasibility of delivery by lay counselors of the treatment, for example expansion of the target group to include alcohol‐dependent patients and the extension of the delivery settings to include home‐based delivery. There was preliminary evidence of the effectiveness of CAP.ConclusionsCAP is an acceptable brief PT for harmful drinking delivered by lay counselors in primary care whose effectiveness is currently being tested in a randomized controlled trial based in primary care in Goa, India.

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

Cited by 253 publications

References 52 publications

Guided Act and Feel Indonesia – Internet-based Behavioral Activation Intervention for Depression in Indonesia: A Systematic Cultural Adaptation

Guided Act and Feel Indonesia – Internet-based Behavioral Activation Intervention for Depression in Indonesia: A Systematic Cultural Adaptation

Model for Service Delivery for Developmental Disorders in Low-Income Countries

The Systematic Development and Pilot Randomized Evaluation of Counselling for Alcohol Problems, a Lay Counselor‐Delivered Psychological Treatment for Harmful Drinking in Primary Care in India: The PREMIUM Study

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