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Cultural adaptations of cognitive behavioural therapy for Latin American patients: unexpected findings from a systematic review

Part of: Being an Anti-Racist CBT therapist

Published online by Cambridge University Press:  21 December 2020

Maria Elena Hernandez Hernandez Open the ORCID record for Maria Elena Hernandez Hernandez [Opens in a new window] ,
Glenn Waller Open the ORCID record for Glenn Waller [Opens in a new window]  and
Gillian Hardy Open the ORCID record for Gillian Hardy [Opens in a new window]
Maria Elena Hernandez Hernandez*
Affiliation:
Department of Psychology, University of Sheffield, Cathedral Court, 1 Vicar Lane, SheffieldS1 2LT, UK
Glenn Waller
Affiliation:
Department of Psychology, University of Sheffield, Cathedral Court, 1 Vicar Lane, SheffieldS1 2LT, UK
Gillian Hardy
Affiliation:
Department of Psychology, University of Sheffield, Cathedral Court, 1 Vicar Lane, SheffieldS1 2LT, UK
*
*Corresponding author. Email: [email protected]
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Abstract

The current literature extensively recommends making cultural adaptations to psychological therapies, in order to address the differences in values, beliefs and attitudes that patients from different ethnic groups might hold. Although this approach has shown positive outcomes in some settings, it is not well established yet whether such adaptations are needed for all therapies and in all cultures. Therefore, the main aim of this study was to systematically review the literature regarding culturally adapted and ‘conventional’ cognitive behavioural therapy (CBT) for Latin American patients, within Latin American and non-Latin American countries. Sixty empirical studies regarding the effectiveness of culturally adapted and conventional CBT were included in this review. The included studies were carried out in Latin American and non-Latin American countries. The information from all studies was synthesized and assessed, including intervention effect sizes, patient retention rates, methodological quality of the papers, and the type of cultural adaptation made to the therapy. There were no differences between the sets of studies in terms of effectiveness, retention rates, methodological quality, or proportion of statistically significant interventions. Most of the cultural adaptations were peripheral or unspecified. The evidence to date indicates that both conventional and culturally adapted CBT offer the same benefits for Latin American patients in terms of effectiveness and retention rates. Rather than focusing on cultural adaptations, clinicians are encouraged to improve the way they deliver CBT through training and supervision.

Key learning aims

  1. (1) Cultural adaptations of CBT do not seem to offer any significant benefits to conventional, non-adapted CBT in Latin American patients.

  2. (2) Most of the adaptations made to CBT for Latin American patients are either peripheral or not disclosed.

  3. (3) We discuss the implications of adapting CBT for Latin American patients when there is no apparent need to do so.

Keywords

cognitive behavioural therapycultural adaptationsLatin Americasystematic review
Type
Review Paper
Information
the Cognitive Behaviour Therapist , Volume 13 , 2020 , e57
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

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References

Further reading

Benuto, L. & O’Donohue, W. (2015). Is culturally sensitive cognitive behavioral therapy an empirically supported treatment?: the case for Hispanics. International Journal of Psychology and Psychological Therapy, 15, 405–421.Google Scholar
Chu, J., & Leino, A. (2017). Advancement in the maturing science of cultural adaptations of evidence-based interventions. Journal of Consulting and Clinical Psychology, 85, 45–57. doi: 10.1037/ccp0000145 CrossRefGoogle ScholarPubMed
Organista, K. C., & Munoz, R. F. (1996). Cognitive behavioural therapy with Latinos. Cognitive and Behavioral Practice, 3, 255–270. doi: 10.1016/S1077-7229(96)80017-4 CrossRefGoogle Scholar

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