Review of Culturally-Adapted Cognitive Behavioral Therapy Interventions for North American Indigenous Children and Youth

Cognitive Behavioral Therapy (CBT) is a widely used and established evidence-based intervention; however the extension of CBT to specific cultural groups may require adaptations to align content and treatment process to cultural beliefs and values. The highly structured and often written nature of CBT might make it less acceptable to Indigenous people. A scoping review of culturally adapted CBT interventions for Indigenous people in North America was conducted. In total, 10 studies were identified that assessed or discussed interventions for trauma, substance use, and internalizing disorders. Studies included diverse Indigenous groups, tended toward small sample sizes, and varied in the level of cultural adaptation. Most included surface level changes, yet comparably fewer studies incorporated deeper structural changes. Overall, reductions in symptoms were demonstrated across interventions targeting various mental health concerns. Methodological limitations within studies inhibit the ability to determine if cultural adaptations led to improved outcomes in comparison to non-adapted interventions.