Exploring cultural adaptations and the cultural fit of trauma-focused cognitive behavioural therapy

Background:
Trauma-focused cognitive behavioural therapy is an evidence-based and recommended intervention for children and young people who develop difficulties following exposure to traumatic events. Simultaneously, the cross-cultural relevance of this intervention is being challenged by clinicians and researchers. Therefore, this study reviewed studies that developed cultural adaptations to traumafocused cognitive behavioural (TF-CBT) interventions for children and young people. The aim of the study was to identify what adaptations were made, how they were made, and if the consequent interventions were effective.

Methodology:
A systematic literature search was carried out which identified twelve eligible studies. The studies were evaluated for methodological quality, quality of the adaptation development process, and replicability of adaptations. Studies were synthesized using narrative synthesis.

Results:
All twelve studies reported that their respective culturally adapted interventions were effective in reducing distress. Four studies were identified as providing methodologically robust findings in support of the intervention. Only two of these provided enough detail describing the adaptations and the development process used for quality and replicability to be assessed.

Conclusions:
TF-CBT seems amenable to cultural adaptation whilst retaining effectiveness, although this finding is limited by the small number of good-quality studies that support this. Clinical and research implications are discussed.