Cultural adaptations of group CBT for depressed clients from diverse backgrounds: A systematic review
Open accessAbstract
Abstract Cognitive behavioural therapy (CBT) is considered a frontline treatment for major depressive disorder (MDD) and is recommended as a preferred option in many Western healthcare settings. CBT has proven effective for clients from the majority population in Western countries, but to meet the needs of diverse clients it may require adaptation. The benefits of culturally adapted group CBT (CA-GCBT) for clients from diverse backgrounds remains uncertain. The objective of this review is to systematically identify, evaluate, and integrate the existing empirical literature on CA-GCBT for depressed clients from diverse backgrounds. A comprehensive search was conducted in April 2021 across various databases, including, MEDLINE, PsycINFO, Cinahl, Academic Search, and APA PsycArticle. Quantitative studies meeting the inclusion criteria resulted in a total of ten articles being included in the review. Results from the analysis revealed a statistically significant reduction in depressive symptoms following CA–GCBT in nine out of the ten studies, with one study providing descriptive results. Additionally, improvements were observed in dysfunctional beliefs, functioning, and quality of life ratings. These findings suggest promising outcomes for racially minoritised clients in Western countries and racial majority clients in non-Western countries. Adaptations in CA-GCBT primarily focus on modifying the group delivery, therapy content, staffing, processes, and client-specific factors. Overall, CA-GCBT shows promise as a treatment for depressed clients from diverse backgrounds. However, further evaluation is necessary to establish its efficacy in clinical practice more robustly, to identify which adaptations are most effective for specific populations and to explore the experiences of implementing or attending such group interventions. Key learning aims (1) To explore the benefits of CA-GCBT for depressed clients from diverse backgrounds. Although CBT is a frontline treatment for MDD and often delivered in group format, it remains unclear whether CA-GCBT is beneficial. (2) To summarise findings about the benefits of CA-GCBT for racially minoritised clients in Western countries and racial majority clients in non-Western countries. (3) To outline the modifications made to common CBT group approaches to enhance cultural responsiveness for clients from diverse backgrounds. (4) To provide support to therapists, healthcare services, and broader healthcare structures seeking to implement evidence-based knowledge when adapting group CBT for diverse cultural groups. This enables them to modify existing group CBT protocols or consider specific CA-GCBT interventions.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Traditional CBT often struggles to address systemic stressors or diverse cultural values because its Western-centric framework primarily focuses on correcting an individual's internal cognitive distortions.
“Traditional CBT often struggles to address systemic stressors or diverse cultural values because its Western-centric framework primarily focuses on correcting an individual’s internal cognitive distortions [16].”
From Advancing Undergraduate Student Mental Healthcare of Social Anxiety Disorder: Evaluating the Acceptance of AR-Assisted Cognitive Behavioral Therapy Through TAM-Based Constructs. (2026) · cites this paper as [16]
The ‘Implicit cultural assumptions within CBT’ section (page not provided) describes CBT as Western-centric and says its focus on changing internal thought patterns can affect its acceptability and efficacy for people whose values or explanations of distress differ. The ‘Culturally adapted CBT’ section discusses asking about racism and micro-aggressions, but the copy does not explicitly say that traditional CBT struggles to address systemic stressors because of its focus on correcting cognitive distortions. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000097 · Cited by 64,042 · see citing works
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267 · see citing works
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910 · see citing works
An inventory for measuring depression
BECK, A. T. (1961) · Archives of General Psychiatry · doi:10.1001/archpsyc.1961.01710120031004 · Cited by 38,032 · see citing works
Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & the PRISMA Group* (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-4-200908180-00135 · Cited by 37,554 · see citing works
The MOS 36-ltem Short-Form Health Survey (SF-36): I. Conceptual Framework and Item Selection
Ware, J. E., & Sherbourne, C. D. (1992) · Medical Care · doi:10.1097/00005650-199206000-00002 · Cited by 30,033 · see citing works
The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., et al. (2021) · International Journal of Surgery · doi:10.1016/j.ijsu.2021.105906 · Cited by 11,748 · see citing works
Assessing coping strategies: A theoretically based approach.
Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.56.2.267 · Cited by 11,682 · see citing works
Assessing coping strategies: A theoretically based approach.
Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.56.2.267 · Cited by 11,507 · see citing works
Practical Statistics for Medical Research
Altman, D. G. (1990) · doi:10.1201/9780429258589 · Cited by 10,668 · see citing works
Development of a Rating Scale for Primary Depressive Illness
Hamilton, M. (1967) · British Journal of Social and Clinical Psychology · doi:10.1111/j.2044-8260.1967.tb00530.x · Cited by 8,410 · see citing works
Beck, A. T., Steer, R. A., & Brown, G. (2011) · PsycTESTS Dataset · doi:10.1037/t00742-000 · Cited by 7,535 · see citing works
(2022) · The Lancet Psychiatry · doi:10.1016/s2215-0366(21)00395-3 · Cited by 6,481 · cited 1× · see citing works
“The Global Burden of Disease (GBD, 2019) reported that depressive disorders accounted for the largest proportion of mental disorders in 2019 (approximately 37.3%).”
BackgroundInfluentialSantomauro, D. F., Mantilla Herrera, A. M., Shadid, J., Zheng, P., Ashbaugh, C., Pigott, D. M., Abbafati, C., Adolph, C., Amlag, J. O., Aravkin, A. Y., et al. (2021) · The Lancet · doi:10.1016/s0140-6736(21)02143-7 · Cited by 5,444 · cited 1× · see citing works
“In addition, Santomauro et al .”
Rush, A. J., Trivedi, M. H., Ibrahim, H. M., Carmody, T. J., Arnow, B., Klein, D. N., Markowitz, J. C., Ninan, P. T., Kornstein, S., Manber, R., et al. (2003) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01866-8 · Cited by 3,829 · see citing works
The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses
Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T., & Fang, A. (2012) · Cognitive Therapy and Research · doi:10.1007/s10608-012-9476-1 · Cited by 3,445 · cited 1× · see citing works
“…(CBT) for the treatment of MDD has demonstrated efficacy compared with control/waitlist groups (Beltman et al ., 2010; Van Straten et al ., 2010) and is as effective as other forms of psychological therapy (Barth et al ., 2013; Cuijpers et al ., 2010; Cuijpers et al ., 2013; Hofmann et al ., 2012).”
BackgroundMethley, A. M., Campbell, S., Chew-Graham, C., McNally, R., & Cheraghi-Sohi, S. (2014) · BMC Health Services Research · doi:10.1186/s12913-014-0579-0 · Cited by 2,706 · see citing works
Is there a universal need for positive self-regard?
Heine, S. J., Lehman, D. R., Markus, H. R., & Kitayama, S. (1999) · Psychological Review · doi:10.1037/0033-295x.106.4.766 · Cited by 2,247 · cited 1× · see citing works
“Genericapplication of CBT could also obstruct the process of change, especially if the therapists ’ explanations are contradictory or not acceptable to the client ’ s cultural model (Jameel et al ., 2022).”
BackgroundChanging the world and changing the self: A two-process model of perceived control.
Rothbaum, F. M., Weisz, J. R., & Snyder, S. S. (1982) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.42.1.5 · Cited by 2,111 · see citing works
(1993) · PubMed · Cited by 1,900 · see citing works
Global burden of depressive disorders in the year 2000
Üstün, T. B., Ayuso-Mateos, J. L., Chatterji, S., Mathers, C., & Murray, C. J. L. (2004) · British Journal of Psychiatry · doi:10.1192/bjp.184.5.386 · Cited by 1,735 · see citing works
Cognitive Therapy of Depression
Fischer, H. (1980) · Psychosomatics · doi:10.1016/s0033-3182(80)73639-3 · Cited by 1,612 · see citing works
Common mental health problems in immigrants and refugees: general approach in primary care
Kirmayer, L. J., Narasiah, L., Munoz, M., Rashid, M., Ryder, A. G., Guzder, J., Hassan, G., Rousseau, C., Pottie, K., & for the Canadian Collaboration for Immigrant and Refugee Health (CCIRH) (2011) · Canadian Medical Association Journal · doi:10.1503/cmaj.090292 · Cited by 1,505 · see citing works
The performance of the Japanese version of the K6 and K10 in the World Mental Health Survey Japan
Furukawa, T. A., Kawakami, N., Saitoh, M., Ono, Y., Nakane, Y., Nakamura, Y., Tachimori, H., Iwata, N., Uda, H., Nakane, H., et al. (2008) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.257 · Cited by 1,478 · see citing works
The increasing burden of depression
Briley, M., & Lépine (2011) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s19617 · Cited by 1,222 · see citing works
Cultural adaptation of treatments: A resource for considering culture in evidence-based practice
Bernal, G., Jiménez-Chafey, M. I., & Domenech Rodríguez, M. M. (2009) · Professional Psychology: Research and Practice · doi:10.1037/a0016401 · Cited by 1,186 · cited 1× · see citing works
“Such adjustments are not ad hoc ; instead, they are systematic modifications of various research-based interventions to ensure that they are compatible (Bernal et al ., 2009).”
BackgroundThe Revised Almost Perfect Scale
Slaney, R. B., Rice, K. G., Mobley, M., Trippi, J., & Ashby, J. S. (2001) · Measurement and Evaluation in Counseling and Development · doi:10.1080/07481756.2002.12069030 · Cited by 1,087 · see citing works
Cuijpers, P., Berking, M., Andersson, G., Quigley, L., Kleiboer, A., & Dobson, K. S. (2013) · The Canadian Journal of Psychiatry · doi:10.1177/070674371305800702 · Cited by 1,066 · see citing works
Psychotherapy for depression in adults: A meta-analysis of comparative outcome studies.
Cuijpers, P., van Straten, A., Andersson, G., & van Oppen, P. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0013075 · Cited by 1,050 · cited 1× · see citing works
“Initially developed as an individual therapy (Beck, 1979), CBT delivered in a group format has been found to be effective, with meta-analyses of RCTs of group CBT for MDD reporting good efficacy (Cuijpers et al ., 2008; Feng et al ., 2012; Huntley et al ., 2012).”
Method(2001) · Medical Entomology and Zoology · Cited by 915 · see citing works
(2001) · PubMed · Cited by 713 · see citing works
Is cognitive–behavioral therapy more effective than other therapies?
Tolin, D. F. (2010) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.05.003 · Cited by 645 · see citing works
A Brief Behavioral Activation Treatment for Depression: Treatment Manual
Lejuez, C. W., Hopko, D. R., & Hopko, S. D. (2001) · Behavior Modification · doi:10.1177/0145445501252005 · Cited by 611 · see citing works
Desjarlais, R., Eisenberg, L., Good, B. J., & Kleinman, A. (1995) · doi:10.1093/oso/9780195095401.001.0001 · Cited by 589 · see citing works
Barth, J., Munder, T., Gerger, H., Nüesch, E., Trelle, S., Znoj, H., Jüni, P., & Cuijpers, P. (2013) · PLoS Medicine · doi:10.1371/journal.pmed.1001454 · Cited by 569 · see citing works
Cuijpers, P., Noma, H., Karyotaki, E., Cipriani, A., & Furukawa, T. A. (2019) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2019.0268 · Cited by 539 · see citing works
Treating Depression in Predominantly Low-Income Young Minority Women
Miranda, J. M., Chung, J. Y., Green, B. L., KRUPNICK, J. L., Siddique, J., Revicki, D. A., & Belin, T. (2003) · JAMA · doi:10.1001/jama.290.1.57 · Cited by 520 · see citing works
Culturally sensitive social work practice with Arab clients in mental health settings
Al-Krenawi, A., & Graham, J. R. (2000) · Health & Social Work · doi:10.1093/hsw/25.1.9 · Cited by 485 · see citing works
Toward a New Generation of Cross-Cultural Research
Matsumoto, D., & Yoo, S. H. (2006) · Perspectives on Psychological Science · doi:10.1111/j.1745-6916.2006.00014.x · Cited by 379 · see citing works
Cuijpers, P., Muñoz, R. F., Clarke, G. N., & Lewinsohn, P. M. (2009) · Clinical Psychology Review · doi:10.1016/j.cpr.2009.04.005 · Cited by 336 · see citing works
Treatment of depression among impoverished primary care patients from ethnic minority groups.
Miranda, J. M., Azocar, F., Organista, K., Dwyer, E., & Areane, P. (2003) · Psychiatric Services · doi:10.1176/appi.ps.54.2.219 · Cited by 281 · see citing works
The Behavioral Activation for Depression Scale–Short Form: Development and Validation
Manos, R. C., Kanter, J. W., & Luo, W. (2011) · Behavior Therapy · doi:10.1016/j.beth.2011.04.004 · Cited by 276 · see citing works
Addressing Cultural Complexities in Practice: Assessment, Diagnosis, and Therapy
Hays, P. A. (2016) · Cited by 264 · see citing works
Social Origins of Distress and Disease; Depression, Neurasthenia, and Pain in Modern China.
Lock, M. M., & Kleinman, A. (1988) · Man · doi:10.2307/2803283 · Cited by 256 · see citing works
Reliability and validity testing of the revised 12-item Short-Form Health Survey in older adults
Resnick, B., & Nahm, E. S. (2001) · Journal of Nursing Measurement · doi:10.1891/1061-3749.9.2.151 · Cited by 255 · see citing works
Globalisation and mental disorders
Bhugra, D., & Mastrogianni, A. (2004) · British Journal of Psychiatry · doi:10.1192/bjp.184.1.10 · Cited by 230 · see citing works
Mind over mood: A cognitive therapy treatment manual for clients.
Greenberger, D., & Padesky, C. A. (1995) · Cited by 221 · see citing works
Cultural factors and international epidemiology
Patel, V. (2001) · British Medical Bulletin · doi:10.1093/bmb/57.1.33 · Cited by 179 · see citing works
Miech, R. A. (2001) · Annals of Epidemiology · doi:10.1016/s1047-2797(00)00079-x · Cited by 162 · see citing works
Jorm, A. F., Morgan, A. J., & Hetrick, S. E. (2008) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007142.pub2 · Cited by 160 · see citing works
Cultural adaptation of cognitive–behavioural therapy
Naeem, F., Phiri, P., Rathod, S., & Ayub, M. (2019) · BJPsych Advances · doi:10.1192/bja.2019.15 · Cited by 159 · see citing works
Colonialism and Psychology of Culture
Okazaki, S., David, E. J. R., & Abelmann, N. (2007) · Social and Personality Psychology Compass · doi:10.1111/j.1751-9004.2007.00046.x · Cited by 155 · see citing works
Tucker, M., & Oei, T. P. S. (2007) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465806003134 · Cited by 154 · cited 1× · see citing works
“These may include possible confrontations between participants, the development of sub-group/cliques, and participants talking over each other (Tucker and Oei, 2007).”
BackgroundBlackburn, I. (1991) · Current Opinion in Psychiatry · doi:10.1097/00001504-199112000-00019 · Cited by 148 · see citing works
Beltman, M. W., Voshaar, R. C. O., & Speckens, A. E. M. (2010) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.109.064675 · Cited by 141 · see citing works
Kohn, L. P., Oden, T., Muñoz, R. F., Robinson, A., & Leavitt, D. (2002) · Community Mental Health Journal · doi:10.1023/a:1020884202677 · Cited by 139 · see citing works
Group psychological therapies for depression in the community: systematic review and meta-analysis
Huntley, A. L., Araya, R., & Salisbury, C. (2012) · British Journal of Psychiatry · doi:10.1192/bjp.bp.111.092049 · Cited by 132 · see citing works
Attachment avoidance and the cultural fit hypothesis: A cross-cultural investigation
Friedman, M., Rholes, W. S., Simpson, J. A., Bond, M. H., DIAZ-LOVING, R., & CHAN, C. (2010) · Personal Relationships · doi:10.1111/j.1475-6811.2010.01256.x · Cited by 124 · see citing works
Social Origins of Distress and Disease: Depression, Neurasthenia, and Pain in Modern China
Lin, K. (1987) · Psychosomatics · doi:10.1016/s0033-3182(87)72500-6 · Cited by 118 · see citing works
The effectiveness of group cognitive behaviour therapy for unipolar depressive disorders
Oei, T. P. S., & Dingle, G. A. (2007) · Journal of Affective Disorders · doi:10.1016/j.jad.2007.07.018 · Cited by 117 · see citing works
The professional counselor : a process guide to helping
Cormier, L. S., & Hackney, H. L. (1993) · Medical Entomology and Zoology · Cited by 115 · see citing works
Effectiveness of cognitive-behavioral therapy with adult ethnic minority clients: A review.
Horrell, S. C. V. (2008) · Professional Psychology Research and Practice · doi:10.1037/0735-7028.39.2.160 · Cited by 114 · see citing works
The Depressed Woman: A Study of Social Relationships
Carlson, H. B. (1975) · American Journal of Psychiatry · doi:10.1176/ajp.132.2.214-a · Cited by 109 · see citing works
The Client Satisfaction Inventory: Results of an Initial Validation Study
McMurtry, S. L., & Hudson, W. W. (2000) · Research on Social Work Practice · doi:10.1177/104973150001000506 · Cited by 106 · see citing works
Using the right words to address racial disparities in COVID-19
Milner, A. N., & Jumbe, S. E. (2020) · The Lancet Public Health · doi:10.1016/s2468-2667(20)30162-6 · Cited by 99 · see citing works
The Coping With Depression Course: Review and future directions.
Lewinsohn, P. M., Clarke, G. N., & Hoberman, H. M. (1989) · Canadian Journal of Behavioural Science / Revue canadienne des sciences du comportement · doi:10.1037/h0079846 · Cited by 95 · see citing works
Psychological treatment of depressive symptoms in patients with medical disorders: a meta-analysis
van Straten, A., Geraedts, A., Verdonck-de Leeuw, I., Andersson, G., & Cuijpers, P. (2010) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2010.01.019 · Cited by 95 · see citing works
Cultural adaptations of cognitive behavioral therapy
Hinton, D. E., & Patel, A. (2017) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2017.08.006 · Cited by 95 · see citing works
An evidence-based framework to culturally adapt cognitive behaviour therapy
Rathod, S., Phiri, P., & Naeem, F. (2019) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x18000247 · Cited by 93 · see citing works
Okumura, Y., & Ichikura, K. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.04.023 · Cited by 86 · see citing works
Cognitive behavioral group therapy for anxiety: recent developments
Wolgensinger, L. (2015) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2015.17.3/lwolgensinger · Cited by 84 · see citing works
Naeem, F., Phiri, P., Munshi, T., Rathod, S., Ayub, M., Gobbi, M., & Kingdon, D. (2015) · International Review of Psychiatry · doi:10.3109/09540261.2015.1067598 · Cited by 84 · cited 2× · see citing works
“Alternative modifications may be focused on homework, whereby some may benefit more from writing in their native language, using symbols with less writing, regular reminders, audio, culturally bound counting (using beads), and involving the family (Naeem et al ., 2015).”
BackgroundNaz, S., Gregory, R., & Bahu, M. (2019) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x19000060 · Cited by 81 · see citing works
Aguilera, A., Garza, M. J., & Muñoz, R. F. (2010) · Journal of Clinical Psychology · doi:10.1002/jclp.20706 · Cited by 80 · see citing works
Cognitive change processes in a group cognitive behavior therapy of depression
Kwon, S., & Oei, T. P. S. (2003) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/s0005-7916(03)00021-1 · Cited by 79 · see citing works
Dreher, M. C. (2003) · Journal of Substance Use · doi:10.1080/14659890306284 · Cited by 78 · see citing works
Kalibatseva, Z., & Leong, F. T. L. (2014) · Psychological Services · doi:10.1037/a0036047 · Cited by 76 · see citing works
Wong, D. F. K. (2008) · Depression and Anxiety · doi:10.1002/da.20286 · Cited by 66 · see citing works
The Effect of Cognitive Behavioral Group Therapy for Depression: A Meta‐Analysis 2000–2010
Feng, C., Chu, H., Chen, C., Chang, Y., Chen, T., Chou, Y., Chang, Y., & Chou, K. (2012) · Worldviews on Evidence-Based Nursing · doi:10.1111/j.1741-6787.2011.00229.x · Cited by 66 · see citing works
Variations by ethnicity in referral and treatment pathways for IAPT service users in South London
Harwood, H., Rhead, R. D., Chui, Z., Bakolis, I., Connor, L., Gazard, B., Hall, J., MacCrimmon, S., Rimes, K. A., Woodhead, C., et al. (2021) · Psychological Medicine · doi:10.1017/s0033291721002518 · Cited by 66 · see citing works
Culturally adapted psychotherapies for depressed adults: A systematic review and meta-analysis
Anik, E., West, R. M., Cardno, A. G., & Mir, G. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.09.051 · Cited by 65 · see citing works
Cultural Adaptation of CBT for Serious Mental Illness: A Guide for Training and Practice
Rathod, S., Kingdon, D., Pinninti, N., Turkington, D., & Phiri, P. (2015) · doi:10.1002/9781118976159 · Cited by 64 · see citing works
Ward, E. C., & Brown, R. (2014) · American Journal of Orthopsychiatry · doi:10.1037/ort0000027 · Cited by 55 · see citing works
Taoist cognitive therapy: treatment of generalized anxiety disorder in a Chinese immigrant woman
Chang, D. F., Hung, T., Ng, N., Ling, A., Chen, T., Cao, Y., & Zhang, Y. (2016) · Asian American Journal of Psychology · doi:10.1037/aap0000052 · Cited by 53 · see citing works
Being an anti-racist clinician
Williams, M. T., Faber, S. C., & Duniya, C. (2022) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x22000162 · Cited by 53 · see citing works
Culturally adapted CBT – the evolution of psychotherapy adaptation frameworks and evidence
Naeem, F., Sajid, S., Naz, S., & Phiri, P. (2023) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x2300003x · Cited by 48 · see citing works
Reliability and validity of the Japanese version of the 24-item Dysfunctional Attitude Scale
田島, 美., Akiyama, T., Numa, H., Kawamura, Y., Okada, Y., Sakai, Y., Miyake, Y., Ono, Y., & Power, M. (2007) · Acta Neuropsychiatrica · doi:10.1111/j.1601-5215.2007.00203.x · Cited by 46 · see citing works
Wong, D. F. K. (2008) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670802203418 · Cited by 45 · see citing works
Recognition of depression in people of different cultures: a qualitative study
Lehti, A., Hammarström, A., & Mattsson, B. (2009) · BMC Family Practice · doi:10.1186/1471-2296-10-53 · Cited by 42 · see citing works
Transcultural Cognitive Behaviour Therapy for Anxiety and Depression
Beck, A. F. (2016) · Routledge eBooks · doi:10.4324/9781315707419 · Cited by 42 · see citing works
Guo, F., & Hanley, T. (2014) · PsyCh Journal · doi:10.1002/pchj.75 · Cited by 41 · see citing works
Ahmad, G., McManus, S., Cooper, C., Hatch, S. L., & Das‐Munshi, J. (2021) · The British Journal of Psychiatry · doi:10.1192/bjp.2021.179 · Cited by 40 · see citing works
Fujisawa, D., Nakagawa, A., Tajima, M., Sado, M., Kikuchi, T., Hanaoka, M., & Ono, Y. (2010) · BMC Research Notes · doi:10.1186/1756-0500-3-160 · Cited by 39 · cited 3× · see citing works
“A common focus of modification was around language, with seven studies (Aguilera et al ., 2018; Fujisawa et al ., 2010; Ito et al ., 2019; Miranda et al ., 2003a; Miranda et al ., 2003b; Wong, 2008a; Wong, 2008b) delivering sessions in the community language through the use of bilingual therapists,…”
BackgroundPerceptions of Depression in a Community Sample in Dubai
Sulaiman, S. O. Y., Bhugra, D., & de Silva, P. (2001) · Transcultural Psychiatry · doi:10.1177/136346150103800204 · Cited by 39 · see citing works
Markova, V., Sandal, G. M., & Pallesen, S. (2020) · BMC Health Services Research · doi:10.1186/s12913-020-05478-x · Cited by 39 · see citing works
Group Therapy Manual for Cognitive-Behavioral Treatment of Depression:
Muñoz, R. F., & Miranda, J. M. (2000) · Cited by 38 · see citing works
Kapadia, D., Brooks, H. L., Nazroo, J. Y., & Tranmer, M. (2015) · Health & Social Care in the Community · doi:10.1111/hsc.12305 · Cited by 37 · see citing works
Proposals for massive expansion of psychological therapies would be counterproductive across society
Summerfield, D. A., & Veale, D. M. (2008) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.107.046961 · Cited by 35 · see citing works
The Subjective Well-Being Inventory (SUBI)
Sell, H. L. (1994) · International Journal of Mental Health · doi:10.1080/00207411.1994.11449289 · Cited by 33 · see citing works
Naeem, F., Ayub, M., Gobbi, M., & Kingdon, D. (2009) · Journal of Pakistan Psychiatric Society · Cited by 31 · see citing works
Transkulturelle Aspekte der Depression
Aichberger, M. C., Schouler-Ocak, M., Rapp, M. A., & Heinz, A. (2008) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-008-0512-y · Cited by 31 · see citing works
Suitability for short-term cognitive-behavioral therapy
Myhr, G., Talbot, J., Annable, L., & Pinard, G. (2007) · Journal of Cognitive Psychotherapy · doi:10.1891/088983907782638743 · Cited by 30 · cited 1× · see citing works
“Based on this cultural context, it is sometimes assumed that individuals are solely responsible for change, so much so, that personal responsibility for change is considered an indicator of suitability for CBT (Myhr et al ., 2007).”
BackgroundImplementing Group CBT for Depression Among Latinos in a Primary Care Clinic
Aguilera, A., Bruehlman-Senecal, E., Liu, N., & Bravin, J. I. (2017) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2017.03.002 · Cited by 28 · see citing works
Beck, A. F. (2019) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x18000223 · Cited by 24 · see citing works
A Systematic Review of Culturally Adapted Behavioral Activation Treatments for Depression
Lehmann, D. C., & Bördlein, C. (2020) · Research on Social Work Practice · doi:10.1177/1049731520915635 · Cited by 24 · see citing works
Lawton, L., McRae, M., & Gordon, L. (2021) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x21000271 · Cited by 23 · see citing works
Öst, L., Enebrink, P., Finnes, A., Ghaderi, A., Havnen, A., Kvale, G., Salomonsson, S., & Wergeland, G. J. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.03.002 · Cited by 22 · see citing works
The integration of CBT, multicultural and feminist psychotherapies with Latinas.
Díaz-Martínez, A. M., Interian, A., & Waters, D. M. (2010) · Journal of Psychotherapy Integration · doi:10.1037/a0020819 · Cited by 18 · see citing works
Jameel, S., Munivenkatappa, M., Arumugham, S. S., & Thennarasu, K. (2022) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x22000137 · Cited by 17 · see citing works
Considerations for Culturally Responsive Cognitive-Behavioural Therapy for Māori With Depression
Bennett, S. T., Flett, R. A., & Babbage, D. R. (2016) · Journal of Pacific Rim Psychology · doi:10.1017/prp.2016.5 · Cited by 16 · see citing works
Rose, S. D. (1999) · Elsevier eBooks · doi:10.1016/b978-012564745-8/50015-7 · Cited by 14 · see citing works
Bhavsar, V., Jannesari, S., McGuire, P. K., MacCabe, J. H., Das‐Munshi, J., Bhugra, D., Dorrington, S., Brown, J. S. L., Hotopf, M. H., & Hatch, S. L. (2021) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-021-02035-7 · Cited by 14 · see citing works
The new reality: Diversity and complexity.
Hays, P. A. (2016) · American Psychological Association eBooks · doi:10.1037/14801-001 · Cited by 9 · see citing works
A Preliminary Study of Work-Focused Cognitive Behavioural Group Therapy for Japanese Workers
Ito, D., Watanabe, A., 竹市, 咲., Ishihara, A., & Yamamoto, K. (2018) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465818000280 · Cited by 9 · see citing works
Adaptation of Cognitive Behaviour Therapy for Depression in Pakistan
Naeem, F. (2012) · ePrints Soton (University of Southampton) · Cited by 7 · see citing works
What is in a name? Autonomic imbalance and medically unexplained symptoms in Taiwan
Chen, J. (2021) · Sociology of Health & Illness · doi:10.1111/1467-9566.13262 · Cited by 7 · see citing works
Hays, P. A. (2018) · American Psychological Association eBooks · doi:10.1037/0000119-001 · Cited by 6 · see citing works
Getting out of the abyss of depression: A cognitive therapy self help manual
Wong, D. F. K. (2005) · Cited by 5 · see citing works
Culturally adapted Family Intervention (CaFI): case examples from therapists’ perspectives
Berry, K., Day, C., Mulligan, L. D., Seed, T., Degnan, A., & Edge, D. (2018) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x18000156 · Cited by 5 · see citing works
Arafat, N. (2021) · Perspectives in Public Health · doi:10.1177/17579139211011502 · Cited by 5 · see citing works
Neurasthenia and autonomic imbalance as minor diagnoses: comparison, concept and implications
Chen, J. (2022) · Social Theory & Health · doi:10.1057/s41285-022-00184-6 · Cited by 5 · see citing works
Are Gains made in IAPT Psychoeducational Groups Maintained over Time? A Qualitative Study
Wykes, C. (2013) · UCL Discovery (University College London) · Cited by 3 · see citing works
Refinement and Pilot Testing of a Culturally Enhanced Treatment for Depressed African-Americans
Bowe, W. M. (2013) · UWM Digital Commons (University of Wisconsin–Milwaukee) · Cited by 2 · see citing works
Richardson, T. H., & Bradbury, K. J. (2012) · Clinical Psychology Forum · doi:10.53841/bpscpf.2012.1.239.45 · Cited by 2 · see citing works
Multicultural Applications of Cognitive Behavior Therapy: A Psychosocial Review
Bhardwaj, M. A. (2016) · International Journal of Indian Psychology · doi:10.25215/0304.176 · Cited by 1 · see citing works
Metzger (1990) · doi:10.1002/1097-4679(199001)46:1
Flagged first, then by citations
Research works printed but not linked: 5
- Beck, A. (2016). Transcultural Cognitive Behaviour Therapy for Anxiety and Depression: A Practical Guide. Routledge.
- Grossmann, K. E., & Grossmann, K. (1991). Attachment Quality as an Organizer of Emotional and Behavioral Responses in a Longitudinal Perspective. Attachment Across the Life Cycle. Tavistock/Routledge.
- Lewinsohn, P. M. (1974). A behavioral approach to depression. In R. J. Freedman, & M. Katz (eds), The Psychology of Depression (pp. 157-174). Wiley.
- Rathod, S., Kingdon, D., Pinninti, N., Turkington, D., & Phiri, P. (2015). Cultural Adaptation of CBT for Serious Mental Illness: A Guide for Training and Practice. John Wiley & Sons.
- Tanoue, A., Ito, D., Shimizu, K., Ohno, M., Shirai, M., Shimada, H. (2012). Depression, social function, and employees' difficulties in returning to work because of depression. Japanese Journal of Behavior Therapy, 38, 11-22. https://doi.org/10. 1017/S1352465818000280 · DOI
Cited by
Sorted by citations
Talwar, S., Osório, C., Sagar, R., Appleton, R., & Billings, J. (2024) · Trauma Violence & Abuse · doi:10.1177/15248380241231603 · Cited by 8 · see citing works
“This could improve the cultural sensitivity of the interventions (Kunorubwe, 2023) offered to South Asian survivors.”
BackgroundCreating a Supportive Work Environment: A Cognitive Behavioral Approach for Nurse Leaders
Zusman, N., Andrews, C. S., Kaslin, V., & Wruble, A. C. K. W. (2025) · Nursing Reports · doi:10.3390/nursrep15030091 · Cited by 5 · see citing works
Kunorubwe, T., O’Leary, C., & Wynne, J. (2025) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x25000194 · Cited by 3 · see citing works
“This approach aligns with recommendations in Kunorubwe (2023) to be mindful of terminology, as it can have real-world impact on the individuals we work with, our colleagues, services, and even policy.”
Gkintoni, E., & Nikolaou, G. (2025) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe16010002 · Cited by 5 · see citing works
Kunorubwe, T. (2025) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x25100263 · Cited by 3 · see citing works
“Additionally, the delivery of ‘ copy and paste CBT ’ (Kunorubwe, 2023) via an interpreter may be misconstrued as ineffective due to language barriers, when in fact the issue may be a lack of cultural adaptation, making the therapy contradictory or unacceptable to the client ’ s cultural model…”
Jarrad, R. A., Karajeh, A. R., Mahmoud, N., ALdasoqi, K. Y. A. A., Hammad, S., & ALassi, A. (2025) · Issues in Mental Health Nursing · doi:10.1080/01612840.2024.2438887 · Cited by 2 · see citing works
“Group focus CBT actively engages patients throughout all stages of therapy, requiring an effective collaborative link between the patient and his therapist (Kunorubwe, 2023).”
Zhou, Z., Zhou, Y., Ouyang, B., Man, S. S., & Chan, A. H. S. (2026) · Healthcare · doi:10.3390/healthcare14131978
“Traditional CBT often struggles to address systemic stressors or diverse cultural values because its Western-centric framework primarily focuses on correcting an individual’s internal cognitive distortions [16].”
Hall, C. D. X., Bao, A., Sabuncu, B. C., Wang, L., Luu, M. N., Mills, J. C., Trang, K., Millender, E., Lane, B. L., Cheung, D. H., et al. (2025) · AIDS Care · doi:10.1080/09540121.2025.2578652
Cognitive-Behavioral Group Therapy: Integrating RESPPECTUS Principles
Gregory, V. L. (2025) · Springer eBooks · doi:10.1007/978-3-032-01666-9_7
Psychoeducation in Child Interventions for Internalizing Problems
Samar, S. M., Swerdin, S., & Terjesen, M. D. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-29009-1.00072-x
Kunorubwe, T., Meek, N., & Pye, R. E. (2026) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x26100713
“This approach follows the guidance of Kunorubwe (2023), who emphasises the importance of being conscious of the language we use.”
Phuentsho, K., Karran, E. L., Appiah, R. P., Fernandez, M., Graham, K., Kumar, S., Sharma, S., Williams, A. C. D. C., Aparnadas, A., & Moseley, G. L. (2026) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-026-01985-x
Katona, K., Jell, G., Bektas, C., & Griffiths, R. (2026) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x26100853
“The authors are aware that this paper is presented in the context of a greater debate on the terminology used to discuss ethnicity in research as the language used can have consequences in real life (Kunorubwe, 2023).”
Lo, K. C., & Akhunzada, Z. U. (2026) · Social Work · doi:10.1007/978-981-95-3440-1_32-1
- Authors
- Kunorubwe, T.
- Corresponding author
- Kunorubwe, Taf
- ORCID
- Kunorubwe, Taf
- Venue
- The Cognitive Behaviour Therapist
- Publisher
- Cambridge University Press (CUP)
- Published
- 2023
- Volume
- 16
- ISSN
- 1754-470X (ISSN-L)
- OpenAlex
- W4389239189
- Cited by
- 15
- References
- 124
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 1
- FWCI
- 0.63
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Cognitive Behaviour Therapist (publishedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- major depressive disorder, cultural adaptation, cultural responsiveness, non-Western countries, depressive symptoms, dysfunctional attitudes, quality of life, group therapy, treatment adaptation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
