A Meta-Analysis of Cultural Adaptations of Psychological Interventions

Forehand and Kotchick (1996) issued a wake-up call to the field to develop culturally responsive interventions. Since that time, 11 meta-analyses on culturally adapted interventions have been conducted. To reconcile the differences of the previous meta analyses, a new meta-analysis was conducted that included 13,998 participants, 95% of whom were non European American, in 78 studies evaluating culturally adapted interventions with psychopathology outcomes. Using a random effects multilevel regression model, the overall effect size (g = 0.67, p <.001) favored the effectiveness of culturally adapted interventions over other conditions (no intervention, other interventions). There was a medium effect size favoring the effectiveness of culturally adapted interventions over unadapted versions of the same intervention (g =.52). The overall effect size was moderated by whether the study involved treatment (g =.76) vs. prevention (g =.25, p =.03) and whether the study involved specific measures of mood or anxiety symptoms (g=.76) vs. general measures of psychopathology (g =.48, p =.02). Culturally adapted interventions had 4.68 times greater odds than other conditions to produce remission from psychopathology (p <.001) in 16 studies that reported remission. There were greater effects in no intervention control designs (marginal odds ratio = 9.80) than in manualized intervention (marginal odds ratio = 3.47, p =.03) or another active, nonmanualized intervention (marginal odds ratio = 3.38, p =.04) comparison designs in remission studies. Research has yet to adequately investigate whether culturally adapted or unadapted interventions impact culture-specific psychopathology. These findings indicate a continuing need for rigor in the conceptualization and measurement of culture specific psychopathology and in developing culturally responsive interventions.