Considerations for Cross-Cultural Adaptations and Implementation of Interpersonal Psychotherapy: A Review.

Abstract

Objective: Strong social relationships are among the best predictors of mental health, physical health, and longevity, regardless of race or culture. Problems with interpersonal relationships are associated with depression, yet few interventions for depression focus on enhancing social capital. Interpersonal psychotherapy (IPT) and its adaptation for adolescents (IPT-A) are effective, evidence-based treatments for depression aimed at mitigating depressive symptoms by strengthening an individual's interpersonal functioning. Although IPT's efficacy has been established with largely White and middle- and high-income samples, this review highlights studies using IPT and IPT-A to treat depression or depressive symptoms among those affected by marginalization or health disparities around the world. Extensive consideration is given to cultural and contextual adaptations, as well as changes in implementation of the intervention, that the studies may have employed.

Methods: A literature search was conducted in three databases. The studies included in the review examined IPT as a treatment for depression and depressive symptoms in communities for whom IPT was not originally validated and who may experience health care disparities (e.g., marginalized communities and low- and middle-income countries).

Results: Forty-nine studies that adapted or adjusted implementation processes of IPT and related therapies across cultures were identified and included. Common adaptations and implementations included culturally appropriate changes to language or vernacular, treatment location, and therapist characteristics. Studies generally supported IPT for individuals facing health care disparities.

Conclusions: Although initially developed and validated with predominantly White, middle- to high-income samples, IPT and IPT-A may be effective and adaptable interventions across cultural settings, requiring culturally and contextually informed adaptations and adjustments to implementation for optimal success.