A systematic review of acceptance and commitment therapy in sub-Saharan Africa: Understanding the cultural adaptations

IF 3.1 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of Contextual Behavioral Science Pub Date : 2026-07-01 Epub Date: 2026-07-04 DOI:10.1016/j.jcbs.2026.101017

Miriam Mukasa Kasozi, Marissa L. Donahue, Michael E. Levin, Melanie M. Domenech Rodríguez, Rosco Kasujja, Christopher Damulira, Jared Vance

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引用次数: 0

Abstract

Background

Acceptance and Commitment Therapy (ACT) is being applied globally (Lim et al., 2024) and shows potential for addressing the significant mental health treatment gap in sub-Saharan Africa (WHO, 2022). This review examined the current evidence on the implementation, reported outcomes, and cultural adaptation of ACT in this region.

Method

Following PRISMA guidelines, a systematic search was conducted across four databases: PsycINFO, PubMed, ProQuest, and Scopus. We conducted a narrative synthesis, including descriptive comparison of study characteristics, reported outcomes, and effect sizes where available.

Results

Nineteen studies met the inclusion criteria. ACT interventions were implemented across diverse populations, including adolescents, university students, healthcare providers, and clinical groups, and were delivered in school, university, community, and healthcare settings. Interventions varied in format, duration, and targeted outcomes, with studies reporting improvements in psychological symptoms, performance-related outcomes, and psychological flexibility. Cultural adaptations were reported in some studies, primarily involving language, delivery structure, or contextual framing, although reporting often lacked specificity. Adaptations were made to language, delivery formats, and contextual factors. Interventions were applied equally among youth and adults, often in group-based settings. Acceptance emerged as the most frequently targeted ACT process. Cultural modifications enhanced both feasibility and acceptability. However, all studies relied on assessment tools developed in Western contexts.

Conclusion

The evidence provides preliminary supportl for the implementation of ACT in SSA across diverse populations and settings. The review highlights the importance of clearer reporting of adaptation processes and greater attention to construct validity and cultural relevance in future research.

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撒哈拉以南非洲接受和承诺疗法的系统回顾：理解文化适应

接受和承诺疗法（ACT）正在全球范围内得到应用（Lim等人，2024年），并显示出解决撒哈拉以南非洲重大精神卫生治疗缺口的潜力（世卫组织，2022年）。本综述审查了该地区实施、报告结果和文化适应方面的现有证据。方法按照PRISMA指南，在PsycINFO、PubMed、ProQuest和Scopus四个数据库中进行系统检索。我们进行了叙述性综合，包括对研究特征、报告结果和效应大小的描述性比较。结果19项研究符合纳入标准。ACT干预措施在不同人群中实施，包括青少年、大学生、卫生保健提供者和临床群体，并在学校、大学、社区和卫生保健机构中实施。干预措施在形式、持续时间和目标结果上各不相同，研究报告了心理症状、表现相关结果和心理灵活性的改善。一些研究报告了文化适应，主要涉及语言、传递结构或语境框架，尽管报告往往缺乏特异性。对语言、交付格式和上下文因素进行了调整。干预措施在青年和成人中同样适用，通常以群体为基础。接受成为ACT考试最常见的目标。文化的改变提高了可行性和可接受性。然而，所有的研究都依赖于在西方背景下开发的评估工具。结论本研究为在不同人群和环境中实施ACT提供了初步支持。该综述强调了在未来研究中更清晰地报告适应过程和更多地关注结构效度和文化相关性的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Contextual Behavioral Science PSYCHOLOGY, CLINICAL-

CiteScore

8.50

自引率

18.00%

发文量

审稿时长

61 days

期刊介绍： The Journal of Contextual Behavioral Science is the official journal of the Association for Contextual Behavioral Science (ACBS). Contextual Behavioral Science is a systematic and pragmatic approach to the understanding of behavior, the solution of human problems, and the promotion of human growth and development. Contextual Behavioral Science uses functional principles and theories to analyze and modify action embedded in its historical and situational context. The goal is to predict and influence behavior, with precision, scope, and depth, across all behavioral domains and all levels of analysis, so as to help create a behavioral science that is more adequate to the challenge of the human condition.