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Adaptation and translation of mental health interventions in Middle Eastern Arab countries: A systematic review of barriers to and strategies for effective treatment implementation
Abstract
AIM: All too often, efficacious psychosocial evidence-based interventions fail when adapted from one culture to another. International translation requires a deep understanding of the local culture, nuanced differences within a culture, established service practices, and knowledge of obstacles and promoters to treatment implementation. This research investigated the following objectives to better facilitate cultural adaptation and translation of psychosocial and mental health treatments in Arab countries: (1) identify barriers or obstacles; (2) identify promoting strategies; and (3) provide clinical and research recommendations. METHODS: This systematic review of 22 psychosocial or mental health studies in Middle East Arab countries identified more barriers (68%) than promoters (32%) to effective translation and adaptation of empirically supported psychosocial interventions. RESULTS: Identified barriers include obstacles related to acceptability of the intervention within the cultural context, community and system difficulties, and problems with clinical engagement processes. Whereas identified promoter strategies centre on the importance of partnering and working within the local and cultural context, the need to engage with acceptable and traditional intervention characteristics, and the development of culturally appropriate treatment strategies and techniques. CONCLUSIONS: Although Arab cultures across the Middle East are unique, this article provides a series of core clinical and research recommendations to assist effective treatment adaptation and translation within Arab communities in the Middle East.
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“Barriers to treatment for Arab people appear to be similar to those experienced by people living in Western countries, and include low mental health literacy, lack of time and the shame associated with seeking mental health treatment (Gearing et al., 2012, Kayrouz et al., 2014, Kayrouz et al., 2015a).”
From A pilot study of self-guided internet-delivered cognitive behavioural therapy for anxiety and depression among Arabs (2016) · cites this paper as Gearing et al., 2012
In the citing paper
“Notwithstanding this potential, the language barrier of the Arabic Wellbeing course being available in English only, may explain the low level of interest and difficulties in recruiting Arabs to the current study.”
From A pilot study of self-guided internet-delivered cognitive behavioural therapy for anxiety and depression among Arabs (2016) · cites this paper as Gearing et al., 2012
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Metadata
- Authors
- Gearing, R. E., Schwalbe, C. S., MacKenzie, M. J., Brewer, K. B., Ibrahim, R. W., Olimat, H. S., Al-Makhamreh, S. S., Mian, I., & Al-Krenawi, A.
- Affiliations
- Columbia University (US)
- Columbia Global Centers Middle East, Amman, Jordan
- The University of Jordan, Jordan
- Al-Balqa Applied University (JO)
- Centre for Addiction and Mental Health (CA)
- Ben-Gurion University of the Negev, Beer Sheva, Israel
- Venue
- International Journal of Social Psychiatry
- Publisher
- SAGE Publications
- Published
- 2012-07-20
- Volume
- 59
- Issue
- 7
- Pages
- 671-681
- ISSN
- 0020-7640 (ISSN-L)
- 1741-2854
- OpenAlex
- W2005114266
- Cited by
- 167
- References
- 46
- Citations by year
- 2026: 12 · 2025: 14 · 2024: 19 · 2023: 15 · 2022: 13 · 2021: 18 · 2020: 19 · 2019: 12 · 2018: 10 · 2017: 8 · 2016: 10 · 2015: 8 · 2014: 5 · 2013: 4
- FWCI
- 0.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Social Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Cultural Competency in Health Care
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- cultural adaptation, cross-cultural translation, mental health interventions, psychosocial interventions, Arab world, Middle East, implementation barriers, implementation strategies, treatment acceptability, community participation, clinical engagement, culturally appropriate treatment
- MeSH terms
- Adolescent, Adult, Aged, Mental Disorders, Child, Child, Preschool, Cultural Characteristics, Female, Health Services Accessibility, Humans, Male, Mental Health Services, Middle Aged, Middle East, Translations, Treatment Outcome, Cultural Competency, Young Adult
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