"Efficacy of a Culturally Adapted Cognitive Behavioral Therapy (CA-CBT) for Depression Among Arab and Asian Adolescents in the United Arab Emirates: A Randomized Controlled Trial"
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 175
- 试验地点
- 2
- 主要终点
- Change in depressive symptoms measured by the PHQ-9 scale
研究概览
简要总结
This study evaluated the effectiveness of a culturally adapted form of Cognitive Behavioural Therapy (CA-CBT) for reducing depression among Arab and Asian adolescents in the United Arab Emirates (UAE). Depression is a major concern for adolescents in the region, where cultural differences and stigma can make standard mental health treatments less effective.
A total of 175 adolescents aged 13-18, from Filipino, Arab, and other Asian backgrounds, were recruited from schools and communities across the UAE. Participants were randomly assigned to one of two groups: (1) an 8-week CA-CBT program delivered in weekly sessions, or (2) a treatment-as-usual (TAU) group who received available community support.
The CA-CBT program was carefully adapted to reflect the cultural and religious values of participants, including family involvement, use of familiar metaphors, and respect for beliefs about mental illness. The goal was to make therapy more relatable, acceptable, and effective.
The main outcome measured was the severity of depression symptoms before and after the 8-week period. Other outcomes included anxiety, stress levels, and dropout rates. The results showed that CA-CBT significantly reduced depression symptoms more than standard care. The program also had fewer dropouts, meaning more students stayed in therapy.
These findings suggest that adapting evidence-based therapy to reflect cultural values can improve mental health outcomes in diverse communities. The research supports the use of culturally sensitive treatments in school and community mental health programs across multicultural societies like the UAE.
详细描述
This study was a two-arm, parallel-group, single-blind randomized controlled trial (RCT) conducted to assess the efficacy of a newly developed Culturally Adapted Cognitive Behavioural Therapy (CA-CBT) for adolescent depression in the multicultural context of the UAE. The trial involved 175 adolescents aged 13-18 from Arab, Filipino, and other Asian backgrounds who met the inclusion criteria of scoring ≥10 on the PHQ-A (Patient Health Questionnaire for Adolescents). Participants were randomized to either the CA-CBT intervention group or a treatment-as-usual (TAU) control group.
The CA-CBT group received an 8-week manualized intervention tailored to the cultural values of Arab and Asian adolescents, including content adaptations (e.g., academic and family stress in Filipinos, spiritual concerns in Arabs), process modifications (e.g., family involvement, religious framing), and therapist training. The Southampton Adaptation Framework (SAF-CaCBT) and PEN-3 model guided the cultural adaptation. Sessions were delivered by trained facilitators fluent in English, with support in Arabic and Tagalog.
The TAU group received standard mental health resources as available in the community, including school counselors and primary care services. All participants were assessed at baseline (T0) and after the intervention (T1) using validated tools including PHQ-A for depression and DASS-21 for anxiety and stress.
Primary analysis used a 2 (Group) x 2 (Time) repeated measures ANOVA. Results showed a significant time-by-group interaction, with CA-CBT participants experiencing a greater reduction in depressive symptoms (mean difference = -6.8, p < .001, ηp² = .095) compared to the TAU group. Dropout rates were significantly lower in the CA-CBT group (10.2%) than in the TAU group (19.5%), supporting higher engagement and cultural congruence.
The study protocol received ethical approval from the Bath Spa University Academic Centre RAK IRB (Ref # BSU-RAK-PSYCH-2025-0011) and was registered prospectively (ISRCTN14751844).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 13 Years 至 18 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adolescents aged 13 to 18 years old
- •Screening positive for mild to moderate depressive symptoms based on the PHQ-9
- •Able to understand and communicate in English, Arabic, or Tagalog
- •Parental/guardian consent and participant assent provided
- •Willing to attend all 8 weekly therapy sessions
排除标准
- •Currently undergoing structured psychotherapy or psychiatric treatment
- •Diagnosed with severe mental disorders (e.g., psychosis, bipolar disorder)
- •Active suicidal ideation requiring emergency intervention
- •Significant cognitive or developmental delays that impede participation
- •Unwilling or unable to commit to full program attendance
- •Exclusion Criteria:
结局指标
主要结局
Change in depressive symptoms measured by the PHQ-9 scale
时间窗: Baseline and post-intervention (8 weeks)
The Patient Health Questionnaire-9 (PHQ-9) will be used to assess the severity of depressive symptoms. Scores range from 0 to 27, with higher scores indicating greater depressive symptom severity. The PHQ-9 is a validated and widely used self-report tool.
次要结局
未报告次要终点
研究者
Jamal D. Magantor
Program Leader , Department of Psychology, Bath Spa University Academic Centre - RAK
Bath Spa University Academic Centre RAK