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Introduction
The UNESCO (United Nations Educational, Scientific and Cultural Organization) universal declaration on cultural diversity defines culture as ‘the set of distinctive spiritual, material, intellectual and emotional features of society or a social group, and that it encompasses, in addition to art and literature, lifestyles, ways of living together, value systems, traditions and beliefs’ (UNESCO, 2001). The term sub-culture is used to refer to minority cultures within a broader dominant culture. This declaration asserts that cultural pluralism pre-supposes respect for human rights. Most importantly, this definition does not limit culture to race, religion or nationality, thus recognizing cultural aspects of groups based on gender, gender preferences, age and disabilities. These values underpin the principle of cultural adaptation of evidence-based psychosocial interventions for people from diverse cultural and sub-cultural backgrounds.
Cognitive behavioural therapy (CBT), like most modern psychotherapies, is underpinned by the European-American values (Hays and Iwamasa, 2006; Naeem et al., 2019; Stone et al., 2018). CBT involves exploration and attempts to modify core beliefs. Core beliefs, underlying assumptions and even the content of automatic thoughts vary across cultures (Sahin and Sahin, 1992; Tam et al., 2007). Cultural and sub-cultural background also influence beliefs about wellbeing, causes of illness and its cure, help-seeking behaviours, healing systems and even the healers (Altweck et al., 2015; Bhugra, 2006; Bhugra and Bhui, 1998; Hagmayer and Engelmann, 2014).
CBT research until recently has primarily focused on white, middle-class, well-educated service users, who are of European-American identities (Suinn, 2003). It is not common practice to report participant’s cultural or religious background in CBT research. Even when the participant’s background is reported, a broader term such as White, Asian or Black is used, ignoring variations among these groups. Similarly, researchers do not record information concerning participants’ sexual orientation (Bowen and Boehmer, 2007).
Culturally adapting CBT is the only way access to this evidence-based therapy can be improved for marginalized communities in Europe and North America and for the local population outside of these regions where more than 80% of the world population lives. It is heartening to see this field grow over the past decade to the extent that it found its place in a special edition of a highly prestigious journal. This special edition, therefore, is a...